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After glucocorticoid withdrawal, diabetes fully resolved; choreiform movements improved with glycemic control and neuroleptics, though residual hemichorea persisted. Follow-up MRI showed striatal gliotic changes, emphasizing timely recognition and reversible metabolic-neurological 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condition did the patient develop after corticosteroid therapy?","Question",{"text":63,"@type":64},"The patient developed new-onset diabetes mellitus and right-sided hemichorea after corticosteroid therapy for nonproliferative glomerulopathy.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How was diabetic striatopathy confirmed in this case?",{"text":68,"@type":64},"Magnetic resonance imaging (MRI) confirmed diabetic striatopathy with hyperintensity in the left lentiform nucleus.",{"name":70,"@type":61,"acceptedAnswer":71},"Can the diabetes and neurological symptoms reverse in steroid-induced cases?",{"text":72,"@type":64},"In this case, diabetes resolved entirely after glucocorticoid withdrawal, and choreiform movements improved significantly with glycemic control and neuroleptics, though residual hemichorea 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Samya Sengupta,2 Shambaditya Das,2 Ritwik Ghosh,3 and Souvik Dubey2  \n1 Department of Endocrinology & Metabolism, Medical College and Hospital, Kolkata 700073, India  \n2 Department of Neuromedicine, Bangur Institute of Neurosciences, IPGMER and SSKM Hospital, Kolkata 700020, India 3 Department of General Medicine, Burdwan Medical College and Hospital, Burdwan 713104, India  \nCorrespondence: Souvik Dubey, MBBS, MD, DM, Department of Neuromedicine, Bangur Institute of Neurosciences, IPGMER and SSKM Hospital, Kolkata  \n700020, India. Email: [drsouvik79@gmail.com](drsouvik79@gmail.com).  \nAbstract  \nDiabetic striatopathy (DS) is a rare neurometabolic complication of poorly controlled diabetes, typically presenting as hemichorea-hemiballismus. It is most often associated with long-standing diabetes but can rarely occur in steroid-induced diabetes. We report the case of a 59-year-old woman with chronic kidney disease and hypertension who developed new-onset diabetes mellitus and right-sided hemichorea following corticosteroid therapy for nonproliferative glomerulopathy. Magnetic resonance imaging (MRI) confirmed DS with hyperintensity in the left lentiform nucleus. Despite initially requiring insulin, her diabetes resolved entirely following glucocorticoid withdrawal. Choreiform movements improved significantly with glycemic control and neuroleptics; however, residual hemichorea persisted. Follow-up MRI revealed gliotic changes in the striatum. This case highlights the importance of recognizing DS as a possible complication of steroid-induced diabetes. Timely identification and glycemic control can reverse both metabolic and neurological complications, although residual deficits may persist. Key Words: diabetic striatopathy, steroid-induced diabetes, hemichorea, chronic kidney disease, reversible diabetes, basal ganglia  \nIntroduction  \nDiabetic striatopathy (DS) is a rare neurological manifestation of uncontrolled diabetes mellitus, typically presenting with hemichorea or hemiballismus [1, 2]. Although most commonly seen in elderly individuals with long-standing type 2 diabetes, acute-onset involuntary movement disorder has also been reported in other types of diabetes, including type 1 diabetes [3] and type 3c diabetes [4] . Only 3 cases of DS in the context of “secondary diabetes”have been reported in the background of an underlying endocrinological pathologies [5-7] . One was acromegaly [5], and the other 2 were glucocorticoid-induced hyperglycemia [6, 7]. Here we describe a unique case of DS occurring in the context of glucocorticoid-induced diabetes in a patient with preexisting chronic kidney disease (CKD) . The case reiterates the importance of the “double-hit hypothesis”in the pathophysiology of DS (ie, acute metabolic insult ontop of preexisting striatal microangiopathy) .  \nCase Presentation  \nA 59-year-old woman presented to the neurology outpatient department with a 2-month history of involuntary movements affecting the right side of her body (lower > upper) . These movements began 1 month after the onset of hyperglycemia. She had a known history of hypertension and CKD, diagnosed 4 years prior. Over this period, her renal function had ranged between stage G3a and G3b, with persistent grade A3 proteinuria. The patient never received dialysis. Her regular medications included telmisartan (40 mg/day), cilnidipine (5 mg/day), atorvastatin (20 mg/day), iron and folic acid  \nsupplements, calcium, and vitamin D3 . Three months prior to presentation to the neurology clinic, she experienced worsening proteinuria [spot urinary albumin creatinine ratio (UACR) 3780 mg/gm (427.14 mg/mmol) (normal reference range: \u003C30 mg/gm; \u003C3.4 mg/mmol)] and a decline in estimated glomerular filtration rate (eGFR) to 40 mL/min/  \n1.73 m² (normal reference range: ≥90 mL/min/1.73 m²) . An antinuclear antibody profile test was negative. A renal biopsy re","cbCaihgWPwA0F7eR","https://ap.wps.com/l/cbCaihgWPwA0F7eR","pdf",484766,"English","# Abstract\n# Introduction\n# Case Presentation\n# Diagnostic Assessment","[{\"question\":\"What condition did the patient develop after corticosteroid therapy?\",\"answer\":\"The patient developed new-onset diabetes mellitus and right-sided hemichorea after corticosteroid therapy for nonproliferative glomerulopathy.\"},{\"question\":\"How was diabetic striatopathy confirmed in this case?\",\"answer\":\"Magnetic resonance imaging (MRI) confirmed diabetic striatopathy with hyperintensity in the left lentiform nucleus.\"},{\"question\":\"Can the diabetes and neurological symptoms reverse in steroid-induced cases?\",\"answer\":\"In this case, diabetes resolved entirely after glucocorticoid withdrawal, and choreiform movements improved significantly with glycemic control and neuroleptics, though residual hemichorea persisted.\"}]","Irreversible Diabetic Striatopathy in Reversible Diabetes - Case Report | PDF",1790704489,13]