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Question:

My sister is visiting and does not have access to a computer in her home. She is searching for any information Stiff Hand Syndrome and the Stiff Man Syndrome. She is 44 and has been insulin dependent since the age of 21. She has been diagnosed with stiff hand syndrome and lives in a remote area of West Virginia and there is not much access to good information. She is specifically searching for how symptoms started, progressed, etc. or people with the above diagnoses that she can correspond with.

Brother (brammer@erols.com)

Answer:

People with long standing or poorly controlled diabetes seem especially vulnerable to a variety of connective tissue syndromes, for the most part involving the upper limbs. These include the stiff hand syndrome and the stiff man syndrome where anti-glutamic acid decarboxylase (anti-GAD) antibodies are present, but also conditions like carpal tunnel syndrome, flexor tenosynovitis and Dupuytren's contracture.

The underlying cause is not fully understood and has been variably ascribed to excessive glycation of collagen where control has been poor, to a local blood vessel changes and lastly to specific autoimmune damage. Sometimes surgical intervention is appropriate and sometimes local corticosteroid injections have been of value. Plasmapheresis has been successful where there are anti-GAD antibodies.

If your sister does not have access to the Internet it looks as though you are going to have to be the intermediary for information. In a previous question and answer, you will find a short recapitulation of what has been said above as well as three references, which you would probably need access to a medical library to explore in full. You also might want to look at Sibbett, W.L., et al, J.Rheumatology, 24:931,1997 and Rosenbloom, A.L., et al, Endocrinology and Metabolism Clinics of North America, 25:273,1996.

DO'B

Original posting 7 Dec 97

  
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Last Updated: Tuesday April 06, 2010 15:08:56
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