Jaafar Nesreen, Khoueiry Maria, Khoury Samia J, Makki Achraf
Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon.
Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon.
Case Rep Neurol Med. 2021 Jan 28;2021:5952724. doi: 10.1155/2021/5952724. eCollection 2021.
Spinal neurosarcoidosis is a rare disease that can manifest as myelopathy, radiculopathy, or cauda equine syndrome. Spinal epidural lipomatosis is also a rare condition resulting from overgrowth of epidural fat tissue causing compressive myelopathy. To our knowledge, there are no reports linking epidural lipomatosis and spinal neurosarcoidosis. . We describe a case of progressive myelitis in the presence of concomitant spinal neurosarcoidosis and epidural lipomatosis which was a challenging diagnosis with complete response to treatment after addressing both diseases. Both etiologies are inflammatory in nature and share similar expression of inflammatory factors such as TNF- and IL-1.
The common inflammatory process involved in these two diseases might explain a pathophysiological interconnection between both diseases that may underlie their concomitant development in our patient. If these two diseases are interconnected, in their pathophysiological mechanism remains a hypothesis that will need further investigation.
脊柱神经结节病是一种罕见疾病,可表现为脊髓病、神经根病或马尾综合征。脊柱硬膜外脂肪增多症也是一种罕见病症,由硬膜外脂肪组织过度生长导致压迫性脊髓病。据我们所知,尚无硬膜外脂肪增多症与脊柱神经结节病相关的报道。我们描述了一例同时存在脊柱神经结节病和硬膜外脂肪增多症的进行性脊髓炎病例,这是一个具有挑战性的诊断,在对两种疾病进行治疗后完全缓解。这两种病因本质上都是炎症性的,并且共享诸如肿瘤坏死因子和白细胞介素 -1 等炎症因子的相似表达。
这两种疾病中涉及的共同炎症过程可能解释了它们之间的病理生理联系,这可能是我们患者中两种疾病同时发生的基础。如果这两种疾病相互关联,其病理生理机制仍然是一个需要进一步研究的假设。