Zusammenfassung
Die spinale epidurale Lipomatose (SEL) der Brust- und Lendenwirbelsäule ist eine seltene Entität, die zur Kompression des Spinalkanals führt. Bei nicht eindeutig geklärter Pathogenese tritt diese am häufigsten bei Patienten mit langzeitigem exogenem oder endogenem Glukokortikoidüberschuss oder morbidem Übergewicht auf, zudem gibt es idiopathische Formen. Die Symptome sind von der Ausprägung der SEL abhängig. Neben asymptomatischen Verläufen können unspezifische Rückenschmerzen, Radiokulopathien und Rückenmarkkompressionssyndrome auftreten. Die Diagnose erfolgt üblicherweise über eine MRT-Darstellung der betroffenen Wirbelsäulensegmente. Die Therapie variiert zwischen dem Absetzen der Glukokortikoide, einer Gewichtsabnahme bis hin zur mehrstufigen dekompressiven Laminektomie. Die folgende Kasuistik stellt den Befund einer SEL bei einem Patienten mit steroidabhängigem Jo-1-Antikörper-Syndrom vor und bietet eine aktuelle Literaturübersicht zu dieser seltenen Erkrankung.
Abstract
Spinal epidural lipomatosis (SEL) of the thoracic and lumbar spine is a rare entity, which leads to compression of the spinal canal. The exact pathogenesis is still unknown. It most commonly occurs in patients with long-term exogenous or endogenous glucocorticoid excess or morbid obesity but there are also idiopathic forms. The symptoms depend on the severity of the SEL and can manifest as clinically asymptomatic, non-specific back pain, radiculopathy up to spinal cord compression. The diagnosis is usually achieved by magnetic resonance imaging (MRI) of the affected spinal segments. The treatment varies between discontinuation of glucocorticoids, weight reduction up to multisegmental decompressive laminectomy. The following case report presents the findings of SEL in a patient with steroid-dependent Jo-1 antibody syndrome and provides a current literature review on this rare disease.
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V.S. Schäfer, W.A. Schmidt, C. Meybaum, V. Rosenkranz und A. Krause geben an, dass kein Interessenkonflikt besteht.
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E. Reinhold-Keller, Hamburg
F. Moosig, Neumünster
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Schäfer, V.S., Schmidt, W.A., Meybaum, C. et al. Spinale epidurale Lipomatose als seltene Nebenwirkung bei steroidabhängigem Jo-1-Antikörper-Syndrom. Z Rheumatol 75, 939–942 (2016). https://doi.org/10.1007/s00393-016-0173-4
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DOI: https://doi.org/10.1007/s00393-016-0173-4