Document Detail


Do glucocorticoids cause spinal epidural lipomatosis? When endocrinology and spinal surgery meet.
MedLine Citation:
PMID:  10707048     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Here, we report pathogenetic aspects of spinal epidural lipomatosis (SEL) based on a literature review. SEL is a rare entity but can cause significant morbidity. Its symptoms can be identical to those of more common disorders such as vertebral and disc disease, and cord lesions (for example, transverse myelitis, multiple sclerosis and syringomyelia). Therefore, it often goes undiagnosed. In addition, SEL occurs in patients on glucocorticoid therapy, which can lead to myopathy, thereby mimicking the motor symptoms of SEL. Glucocorticoids seem to play a major role in the development of SEL, although idiopathic SEL has also been reported. The latter occurs almost exclusively in obese individuals who may have concurrent hypercortisolism. Once clinically suspected, SEL is best diagnosed by magnetic resonance imaging (MRI). Treatment of SEL is directed at reducing body weight in patients with idiopathic SEL, and at decreasing glucocorticoid excess in patients with endogenous or exogenous hypercortisolism. In severe cases, decompressive laminectomy might become necessary to alleviate the neurological symptoms caused by spinal cord compression.
Authors:
C A Koch; J L Doppman; N J Patronas; L K Nieman; G P Chrousos
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Trends in endocrinology and metabolism: TEM     Volume:  11     ISSN:  1043-2760     ISO Abbreviation:  Trends Endocrinol. Metab.     Publication Date:  2000 Apr 
Date Detail:
Created Date:  2001-03-02     Completed Date:  2001-03-15     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  9001516     Medline TA:  Trends Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  86-90     Citation Subset:  IM    
Affiliation:
Developmental Endocrinology Branch, National Institute of Child Health and Human Development, Bethesda, Maryland 20892, USA.
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MeSH Terms
Descriptor/Qualifier:
Epidural Space
Glucocorticoids / adverse effects*
Humans
Lipomatosis / chemically induced*,  therapy
Spinal Cord Diseases / chemically induced*
Chemical
Reg. No./Substance:
0/Glucocorticoids

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