Footnotes Author Contributions Conceived the concepts: MNB. Analyzed the data: selleck MNB. Wrote the first draft of the manuscript: MNB. Made critical revisions: MNB. The author reviewed and approved of the final manuscript. ACADEMIC EDITOR: Athavale Nandkishor, Associate Editor FUNDING: Author discloses no funding source. COMPETING INTERESTS: Author discloses no potential conflicts of

interest. Paper subject to independent expert blind peer review by minimum of two reviewers. All editorial decisions made by independent academic editor. Upon submission manuscript was subject to anti-plagiarism scanning. Prior to publication all authors have given signed confirmation of agreement to article publication and compliance with all applicable ethical and legal requirements, including the accuracy of author and contributor information, disclosure of competing interests and funding sources, compliance with ethical requirements relating to human and animal study participants, and compliance with any copyright requirements of third parties. This journal is a member of the Committee on Publication Ethics (COPE).
A female in her 20s with a past medical history of asthma, DM1, and postpartum depression presented to the emergency department because of difficulty ambulating associated with lower extremity weakness

and worsening leg pain. The lower extremity weakness, mainly in the left leg, was associated with difficulty in walking, which began a month prior. The pain was only in the left leg, which started in her left lateral thigh and radiated down to left foot. It was very severe (10/10), described as muscle cramp-like in nature, and had progressively gotten worse over the course of five days prior

to presentation. She also stated that the left foot was swollen previously, which was not related to trauma. These symptoms were preceded by newly diagnosed DM1 with diabetic ketoacidosis and profound unintentional weight loss. Her family history was positive for rheumatoid arthritis. On review of her symptoms, the patient admitted blurry vision, occasional headaches, and occasional back pain. She denied any loss of sensation Brefeldin_A or tingling in her extremities, change in bladder or bowel habits, dizziness or falls, or any recent infection. She had been in her usual state of good health until a month after delivery. Upon physical examination, vital signs were within normal range, except for a heart rate of 93, presumably due to pain. The patient weighed 46 kg with a BMI of 16.9. There was tenderness on palpation of the left ankle and foot. On neurological examination, cranial nerves 2–12 were grossly intact, deep tendon reflexes were 2+ bilaterally in the upper and lower extremities, and the strength in the left and right lower extremities were noted as 3/5 and 5/5, respectively. The rest of her physical examination was noncontributory. Laboratory findings were pertinent for hemoglobin of 10.