Hydroxychloroquine used to treat diabetic hand syndrome: a case report

Increased incidence of musculoskeletal disorders has been linked with diabetes mellitus (DM). Focus of antidiabetic therapy is prominently towards controlling blood glucose levels along with prevention and management of micro- and macrovascular complications. These complaints often receive less attention and are undertreated. No specific drug treatment has been recommended for the management of musculoskeletal complications of DM. Hydroxychloroquine (HCQ) decreases joint inflammation and pain in rheumatoid arthritis (RA). In India, due to its proven antidiabetic effect, it is officially approved for the management of type 2 diabetes mellitus (T2DM). Due to its antiinflammatory and antidiabetic effect, it may alter the clinical course of musculoskeletal complications in T2DM patients. We report a case of 55-year-old male patient, diagnosed with T2DM since last 6 years. The patient had bilateral musculoskeletal involvement of upper extremities at the time of presentation. He had difficulty in moving smaller joints of hand, closing of fist and trigger finger, all suggestive of diabetic hand syndrome. Good improvement in joint mobility was observed after initiation of HCQ 400 mg once daily as add-on to existing antidiabetic regimen. HCQ was found to be effective in relieving symptoms of musculoskeletal complications as well as controlling blood glucose level in our patient. More clinical studies investigating use of HCQ in diabetic musculoskeletal complications are warranted.