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Epidural spinal lipomatosis with acute onset of paraplegia in an HIV-positive patient treated with corticosteroids and protease inhibitor: case report.

AbstractSTUDY DESIGN:
Case report.
OBJECTIVE:
To report a case of HIV-related lipodystrophy with a rapid onset of symptoms from epidural lipomatosis in the wake of protease inhibitor and steroid treatment.
SUMMARY OF BACKGROUND DATA:
Symptomatic spinal epidural lipomatosis is considered to be a rare condition usually presenting with slowly progressive cord or nerve root compression. Only 2 cases of spinal lipomatosis in HIV-related lipodystrophy have been reported.
METHODS:
We describe the case of a 41-year-old male with HIV who received protease inhibitor medication and had neurologic deficits rapidly develop.
RESULTS:
The patient had complete paraplegia develop within 12 hours from admission following a 1-day history of unsteady gait and a 3-day history of leg numbness. After diagnosis of epidural lipomatosis on magnetic resonance imaging, the patient underwent decompressive thoraco-laminectomy. He recovered well and was able to walk by postoperative day 4.
CONCLUSION:
It is important to maintain an awareness for the possible association between HIV lipodystrophy and symptomatic epidural lipomatosis.
AuthorsGiles H Vince, Claudia Brucker, Peter Langmann, Christian Herbold, Laszlo Solymosi, Klaus Roosen
JournalSpine (Spine (Phila Pa 1976)) Vol. 30 Issue 17 Pg. E524-7 (Sep 01 2005) ISSN: 1528-1159 [Electronic] United States
PMID16135977 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Glucocorticoids
  • Protease Inhibitors
  • Quinolines
  • sequinavir
  • Asparagine
  • Methylprednisolone
Topics
  • Acute Disease
  • Adenocarcinoma (drug therapy, secondary)
  • Adult
  • Asparagine (adverse effects, analogs & derivatives, therapeutic use)
  • Cerebellar Neoplasms (drug therapy, secondary)
  • Decompression, Surgical
  • Epidural Space
  • Glucocorticoids (adverse effects, therapeutic use)
  • HIV-Associated Lipodystrophy Syndrome (complications, drug therapy, surgery)
  • Humans
  • Laminectomy
  • Lipomatosis (complications, diagnosis, surgery)
  • Magnetic Resonance Imaging
  • Male
  • Methylprednisolone (adverse effects, therapeutic use)
  • Myelography
  • Paraplegia (chemically induced)
  • Protease Inhibitors (adverse effects, therapeutic use)
  • Quinolines (adverse effects, therapeutic use)
  • Spinal Diseases (complications, diagnosis, surgery)

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