Dawman Lesa, Bhattacharya Deepanjan, Sharawat Indar Kumar, Indla Ravi Teja, Bhatia Anmol, Tiewsoh Karalanglin
Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Childs Nerv Syst. 2019 Aug;35(8):1401-1405. doi: 10.1007/s00381-019-04141-z. Epub 2019 Apr 2.
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.
内脏脂肪组织过度增生导致弥漫性脂肪瘤病，是长期类固醇治疗的一种罕见并发症。一名10岁男孩出现严重的神经根性背痛，伴有下肢活动受限。他被诊断为类固醇抵抗型肾病综合征，且接受不规范的类固醇治疗。脊柱磁共振成像显示腰骶部脊柱硬膜外间隙脂肪组织增多，导致马尾神经根聚集，同时肾窦及腹膜脂肪明显增生。他开始服用普瑞巴林并逐渐减少类固醇用量，此后疼痛逐渐减轻，活动能力有所改善。我们的患者因类固醇使用过量继发了累及脊柱硬膜外间隙、双侧肾窦和腹膜的弥漫性脂肪瘤病。随着先进成像技术的出现，通过明智且合理地使用类固醇并密切随访任何不良并发症，这种情况是可以预防的。
