Corticosteroid-induced spinal epidural lipomatosis in the pediatric age group: report of a new case and updated analysis of the literature.
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Authors
Möller, Jana CCron, Randy Q
Young, Daniel W
Girschick, Hermann J
Levy, Deborah M
Sherry, David D
Kukita, Akiko
Saijo, Kaoru
Pessler, Frank
Issue Date
2011
Metadata
Show full item recordAbstract
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.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 JAffiliation
Helmholtz Centre for infection research, Inhoffenstr. 7, D-38124 Braunschweig, Germany.PubMed ID
21284882Type
ArticleLanguage
enISSN
1546-0096ae974a485f413a2113503eed53cd6c53
10.1186/1546-0096-9-5
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