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Lipomatosis of spinal epidural space, peritoneum, and renal sinus: a rare complication of long-term steroid therapy in a child with nephrotic syndrome

  • Lesa DawmanEmail author
  • Deepanjan Bhattacharya
  • Indar Kumar Sharawat
  • Ravi Teja Indla
  • Anmol Bhatia
  • Karalanglin Tiewsoh
Case Report
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Abstract

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.

Keywords

Diffuse lipomatosis Steroid toxicity Adipose tissue Epidural fat 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Lesa Dawman
    • 1
    Email author
  • Deepanjan Bhattacharya
    • 1
  • Indar Kumar Sharawat
    • 1
  • Ravi Teja Indla
    • 1
  • Anmol Bhatia
    • 2
  • Karalanglin Tiewsoh
    • 1
  1. 1.Department of PediatricsPostgraduate Institute of Medical Education and ResearchChandigarhIndia
  2. 2.Department of Radiodiagnosis and ImagingPostgraduate Institute of Medical Education and ResearchChandigarhIndia

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