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Epidural lipomatosis as a cause of spinal cord compression in polymyalgia rheumatica
1Borgess Medical Center, Kalamazoo, MI.
Abstract:
Polymyalgia rheumatica (PMR) is a common rheumatologic disorder in older individuals that usually requires chronic, low dose corticosteroid therapy for adequate control of symptoms. Epidural lipomatosis is a rare complication of chronic corticosteroid use in which neurologic deficits occur due to extradural fat compression of the spinal cord. The author describes the first reported case of epidural lipomatosis occurring as a complication of corticosteroid therapy in a patient with PMR.
Insights
Polymyalgia rheumatica (PMR) patients on long-term corticosteroids may develop epidural lipomatosis, a rare condition causing spinal cord compression. This case highlights a potential complication of PMR treatment.
Area of Science:
- Rheumatology
- Neurology
- Medical Complications
Background:
- Polymyalgia rheumatica (PMR) is a prevalent inflammatory condition in the elderly, often managed with long-term, low-dose corticosteroids.
- Chronic corticosteroid use is associated with various side effects, including rare complications affecting the spine.
Observation:
- This report details the first case of epidural lipomatosis in a patient diagnosed with polymyalgia rheumatica.
- Epidural lipomatosis involves the abnormal accumulation of fat in the epidural space, potentially leading to neurological deficits.
Findings:
- The patient with PMR developed epidural lipomatosis as a complication of their corticosteroid treatment.
- This condition resulted in neurological symptoms attributed to the compression of the spinal cord by extradural fat.
Implications:
- Recognizing epidural lipomatosis is crucial for clinicians managing polymyalgia rheumatica patients on long-term corticosteroid therapy.
- Early diagnosis and management may prevent irreversible neurological damage associated with spinal cord compression.