Epidural spinal lipomatosis with acute onset of paraplegia in an HIV-positive patient treated with corticosteroids and protease inhibitor: case report.
METHODS
Case report.


OBJECTIVE
To report a case of HIV-related lipodystrophy with a rapid onset of symptoms from epidural lipomatosis in the wake of protease inhibitor and steroid treatment.


BACKGROUND
Symptomatic spinal epidural lipomatosis is considered to be a rare condition usually presenting with slowly progressive cord or nerve root compression. Only 2 cases of spinal lipomatosis in HIV-related lipodystrophy have been reported.


METHODS
We describe the case of a 41-year-old male with HIV who received protease inhibitor medication and had neurologic deficits rapidly develop.


RESULTS
The patient had complete paraplegia develop within 12 hours from admission following a 1-day history of unsteady gait and a 3-day history of leg numbness. After diagnosis of epidural lipomatosis on magnetic resonance imaging, the patient underwent decompressive thoraco-laminectomy. He recovered well and was able to walk by postoperative day 4.


CONCLUSIONS
It is important to maintain an awareness for the possible association between HIV lipodystrophy and symptomatic epidural lipomatosis.
Vince
Giles H
GH
Department of Neurosurgery, Julius-Maximilians University, Wuerzburg, Germany. gvince@gmx.de
Brucker
Claudia
C
Langmann
Peter
P
Herbold
Christian
C
Solymosi
Laszlo
L
Roosen
Klaus
K
D000208:Acute Disease; D000230:Adenocarcinoma / Q000188:drug therapy / Q000556:secondary; D000328:Adult; D001216:Asparagine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D002528:Cerebellar Neoplasms / Q000188:drug therapy / Q000556:secondary; D019299:Decompression, Surgical; D004824:Epidural Space; D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use; D039682:HIV-Associated Lipodystrophy Syndrome / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D007796:Laminectomy; D008068:Lipomatosis / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008775:Methylprednisolone / Q000009:adverse effects / Q000627:therapeutic use; D009192:Myelography; D010264:Paraplegia / Q000139:chemically induced*; D011480:Protease Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D011804:Quinolines / Q000009:adverse effects / Q000627:therapeutic use; D013122:Spinal Diseases / Q000150:complications* / Q000175:diagnosis / Q000601:surgery
D005938:Glucocorticoids; D011480:Protease Inhibitors; D011804:Quinolines; C508896:sequinavir; D001216:Asparagine; D008775:Methylprednisolone