Möller J, Girschick H J, Hahn G, Pessler F
Klinik und Poliklinik für Kinder- und Jugendmedizin, Fetscherstrasse 74, Dresden, Germany.
Z Rheumatol. 2010 Jul;69(5):447-9. doi: 10.1007/s00393-010-0608-2.
We describe three adolescent patients with chronic autoimmune disorders who developed back pain and, in two cases, spinal symptoms several months after initiating chronic treatment with glucocorticoids. In all cases, MRI showed extensive spinal epidural lipomatosis, a rare but classic untoward effect of chronic glucocorticoid therapy. Analysis of these three, as well as 11 other pediatric cases extracted from the international literature, revealed that spinal epidural lipomatosis manifests most commonly with back pain and within a mean of 1.3 years (range, 3 month-6.5 years) after initiation of therapy with corticosteroids. It frequently remits after reduction of the corticosteroid dose.
我们描述了三名患有慢性自身免疫性疾病的青少年患者,他们在开始使用糖皮质激素进行长期治疗数月后出现背痛,其中两例还出现了脊柱症状。在所有病例中,磁共振成像(MRI)显示广泛的脊髓硬膜外脂肪增多症,这是慢性糖皮质激素治疗罕见但典型的不良反应。对这三例以及从国际文献中提取的其他11例儿科病例的分析显示,脊髓硬膜外脂肪增多症最常见的表现是背痛,且在开始使用皮质类固醇治疗后的平均1.3年(范围为3个月至6.5年)内出现。在减少皮质类固醇剂量后,病情常可缓解。