Analysis of Factors Associated with Charcot Neuroarthropathy following Pancreatic Transplantation

Abstract

Charcot neuroarthropathy (CN) is a progressive neuropathic complication of diabetes mellitus. Patients undergoing pancreatic transplantation are at risk of developing CN, and CN is known to be a poor prognostic factor for graft loss and patient death. This study aimed to investigate the factors associated with CN in patients who had undergone pancreatic transplantation. We analyzed the data of 61 patients who underwent pancreatic transplantations to investigate the relationship between patient background, nerve conduction velocity tests prior to transplantation, and CN onset. Of these patients, six developed CN. The cumulative incidence rates at 1, 3, and 5 years after transplantation were 3.3, 6.9, and 9.0%, respectively. Sensory neuropathy was severe in six patients with CN, with no sural nerve waveform detected. CN development was not observed when the sural nerve waveforms were visualized. However, when no sural nerve waveforms were observed, the incidence of CN significantly increased due to high-dose corticosteroid administration (p = 0.036). High-dose corticosteroids are associated with the development of CN in the presence of severe neuropathy. Corticosteroid administration is associated with bone metabolism; therefore, appropriate therapeutic intervention is required.