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A 21 year-old Caucasian girl presented to her pediatrician with a three day history of pre-tibial numbness extending from her knee to her ankle. She denied numbness in this area or elsewhere on her body before. She denied any traumatic event. She noted a 70-pound unintentional weight loss over the past 9 months. She described the numbness as "pins and needles". She denied pain, muscle weakness, difficulty walking, altered mental status, polydipsia, polyuria, and polyphagia. She denied tobacco,doi:10.5455/2349-3291.ijcp20140806 fatcat:sgqipxnnhzf25lue2azuafh3ju