Lipomatosis of spinal epidural space, peritoneum, and renal sinus: a rare complication of long-term steroid therapy in a child with nephrotic syndrome
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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.
KeywordsDiffuse lipomatosis Steroid toxicity Adipose tissue Epidural fat
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Conflict of interest
The authors declare that they have no conflict of interest.
- 1.Zargar AH, Laway BA, Masoodi SR, Bhat MH, Bashir MI, Wani AI, Wani NA (2003) Diffuse abdominal lipomatosis. J Assoc Physicians India 51:621–622Google Scholar
- 6.Lee M, Lekias J, Gubbay SS, Hurst PE (1975) Spinal cord compression by extradural fat after renal transplantation. Med J Aust 1:201–203Google Scholar
- 8.Perling LH, Laurent JP, Cheek WR (1988) Epidural hibernoma as a complication of corticosteroid treatment. Case report J Neurosurg 69:613–616Google Scholar
- 16.Shirai I, Ando K (1990) Spinal epidural lipomatosis during steroid therapy (in Japanese). Shoni Naika 22:795–799Google Scholar
- 17.Kano K, Kuwashima S, Kyo K, Ando T, Ichimura T (1996) Steroid-induced epidural lipomatosis in nephritic children: early recognition with MR imaging. Dokkyo J Med Sci 23:185–191Google Scholar
- 20.Fassett DR, Schmidt MH (2004) Spinal epidural lipomatosis: a review of its causes and recommendations for treatment. Neurosurg Focus 16:E11Google Scholar
- 24.Fotis L, Koglmeier J, Shah N (2013) Peritoneal lipomatosis: a case report of a 12-year-old boy. Case Rep Gastrointest Med 2013:496419Google Scholar