Corticosteroid-induced spinal epidural lipomatosis in the pediatric age group: report of a new case and updated analysis of the literature.

2.50
Hdl Handle:
http://hdl.handle.net/10033/594407
Title:
Corticosteroid-induced spinal epidural lipomatosis in the pediatric age group: report of a new case and updated analysis of the literature.
Authors:
Möller, Jana C; Cron, Randy Q; Young, Daniel W; Girschick, Hermann J; Levy, Deborah M; Sherry, David D; Kukita, Akiko; Saijo, Kaoru; Pessler, Frank
Abstract:
Spinal epidural lipomatosis is a rare complication of chronic corticosteroid treatment. We report a new pediatric case and an analysis of this and 19 pediatric cases identified in the international literature. The youngest of these combined 20 patients was 5 years old when lipomatosis was diagnosed. Lipomatosis manifested after a mean of 1.3 (+/- 1.5) years (SD) (median, 0.8 years; range, 3 weeks - 6.5 years) of corticosteroid treatment. The corticosteroid dose at the time of presentation of the lipomatosis ranged widely, between 5 and 80 mg of prednisone/day. Back pain was the most common presenting symptom. Imaging revealed that lipomatosis almost always involved the thoracic spine, extending into the lumbosacral region in a subset of patients. Predominantly lumbosacral involvement was documented in only two cases. Although a neurological deficit at presentation was documented in about half of the cases, surgical decompression was not performed in the cases reported after 1996. Instead, reducing the corticosteroid dose (sometimes combined with dietary restriction to mobilize fat) sufficed to induce remission. In summary, pediatric spinal epidural lipomatosis remains a potentially serious untoward effect of corticosteroid treatment, which, if recognized in a timely manner, can have a good outcome with conservative treatment.
Affiliation:
Helmholtz Centre for infection research, Inhoffenstr. 7, D-38124 Braunschweig, Germany.
Citation:
Corticosteroid-induced spinal epidural lipomatosis in the pediatric age group: report of a new case and updated analysis of the literature. 2011, 9 (1):5 Pediatr Rheumatol Online J
Journal:
Pediatric rheumatology online journal
Issue Date:
2011
URI:
http://hdl.handle.net/10033/594407
DOI:
10.1186/1546-0096-9-5
PubMed ID:
21284882
Type:
Article
Language:
en
ISSN:
1546-0096
Appears in Collections:
publications of the research group biomarker in infection and immunity [[TC] BIOM)

Full metadata record

DC FieldValue Language
dc.contributor.authorMöller, Jana Cen
dc.contributor.authorCron, Randy Qen
dc.contributor.authorYoung, Daniel Wen
dc.contributor.authorGirschick, Hermann Jen
dc.contributor.authorLevy, Deborah Men
dc.contributor.authorSherry, David Den
dc.contributor.authorKukita, Akikoen
dc.contributor.authorSaijo, Kaoruen
dc.contributor.authorPessler, Franken
dc.date.accessioned2016-01-20T14:24:12Zen
dc.date.available2016-01-20T14:24:12Zen
dc.date.issued2011en
dc.identifier.citationCorticosteroid-induced spinal epidural lipomatosis in the pediatric age group: report of a new case and updated analysis of the literature. 2011, 9 (1):5 Pediatr Rheumatol Online Jen
dc.identifier.issn1546-0096en
dc.identifier.pmid21284882en
dc.identifier.doi10.1186/1546-0096-9-5en
dc.identifier.urihttp://hdl.handle.net/10033/594407en
dc.description.abstractSpinal epidural lipomatosis is a rare complication of chronic corticosteroid treatment. We report a new pediatric case and an analysis of this and 19 pediatric cases identified in the international literature. The youngest of these combined 20 patients was 5 years old when lipomatosis was diagnosed. Lipomatosis manifested after a mean of 1.3 (+/- 1.5) years (SD) (median, 0.8 years; range, 3 weeks - 6.5 years) of corticosteroid treatment. The corticosteroid dose at the time of presentation of the lipomatosis ranged widely, between 5 and 80 mg of prednisone/day. Back pain was the most common presenting symptom. Imaging revealed that lipomatosis almost always involved the thoracic spine, extending into the lumbosacral region in a subset of patients. Predominantly lumbosacral involvement was documented in only two cases. Although a neurological deficit at presentation was documented in about half of the cases, surgical decompression was not performed in the cases reported after 1996. Instead, reducing the corticosteroid dose (sometimes combined with dietary restriction to mobilize fat) sufficed to induce remission. In summary, pediatric spinal epidural lipomatosis remains a potentially serious untoward effect of corticosteroid treatment, which, if recognized in a timely manner, can have a good outcome with conservative treatment.en
dc.language.isoenen
dc.titleCorticosteroid-induced spinal epidural lipomatosis in the pediatric age group: report of a new case and updated analysis of the literature.en
dc.typeArticleen
dc.contributor.departmentHelmholtz Centre for infection research, Inhoffenstr. 7, D-38124 Braunschweig, Germany.en
dc.identifier.journalPediatric rheumatology online journalen

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