Lipomatosis of spinal epidural space, peritoneum, and renal sinus: a rare complication of long-term steroid therapy in a child with nephrotic syndrome.

Autor: Dawman L; Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India. lesadawman@gmail.com., Bhattacharya D; Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India., Sharawat IK; Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India., Indla RT; Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India., Bhatia A; Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India., Tiewsoh K; Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Jazyk: angličtina
Zdroj: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery [Childs Nerv Syst] 2019 Aug; Vol. 35 (8), pp. 1401-1405. Date of Electronic Publication: 2019 Apr 02.
DOI: 10.1007/s00381-019-04141-z
Abstrakt: Excessive visceral adipose tissue proliferation, resulting in diffuse lipomatosis, is a rare complication of long-term steroid therapy. A 10-year-old boy presented with severe radicular back pain with limitation of lower limb movements. He was diagnosed with steroid-resistant nephrotic syndrome and was on unregulated steroid therapy. Magnetic resonance imaging of the spine showed increased adipose tissue in the epidural space of the lumbo-sacral spine causing clumping of cauda equina nerve roots along with marked proliferation of fat in the renal sinus as well as peritoneum. He was started on pregabalin with tapering of steroids, following which there was a gradual decrease in pain and improvement of activity. Our patient had diffuse lipomatosis involving spinal epidural space, bilateral renal sinus, and peritoneum, secondary to steroid overuse. With the availability of advanced imaging techniques, the condition can be prevented by judicious and proper use of steroids with close follow-up for any untoward complications.
Databáze: MEDLINE