Is epidural lipomatosis associated with abnormality of body fat distribution? A case report.
To report a case of epidural lipomatosis in a patient with abnormal adipose tissue distribution, glucose intolerance and mixed hyperlipidemia. A 63-year-old male patient presented with low back pain radiating to the left calf on standing and walking (walking distance <100 m). He weighed 97.5 kg, was 1.73 m tall (BMI 32.6 kg/m2) and had a waist circumference of 113 cm. He had a glucose intolerance after a 75-g glucose oral load test. CT-Myelography revealed voluminous epidural lipomatosis around L4-L5 and L5-S1. Low calorie diet and reduction in alcohol intake achieved a weight loss of 17.5 kg in 7 months (80 kg, BMI 25.8 kg/m2, waist circumference 94 cm) and dramatic improvement in low back pain, walking distance (>500 m) and reduction of lipomatosis on CT-scan. Our case suggests a relationship between central obesity phenotype and epidural lipomatosis. Specific insulin resistance treatment might be proposed for these patients if this hypothesis is confirmed in further studies.
Maillot
François
F
Internal Medicine, University Hospital, Tours, France.
Mulleman
Denis
D
Mammou
Saloua
S
Goupille
Philippe
P
Valat
Jean-Pierre
JP
D050218:Body Fat Distribution / Q000009:adverse effects*; D002908:Chronic Disease; D003131:Combined Modality Therapy; D004824:Epidural Space; D005500:Follow-Up Studies; D018149:Glucose Intolerance; D006801:Humans; D006949:Hyperlipidemias / Q000175:diagnosis* / Q000628:therapy; D008068:Lipomatosis / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D017116:Low Back Pain; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D009192:Myelography; D018570:Risk Assessment; D012720:Severity of Illness Index; D013118:Spinal Cord Diseases / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy