title: Epidural spinal lipomatosis with acute onset of paraplegia in an HIV-positive patient treated with corticosteroids and protease inhibitor: case report.
abstract: 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.
authors.affiliation: Department of Neurosurgery, Julius-Maximilians University, Wuerzburg, Germany. gvince@gmx.de
authors.forename: Giles H
authors.initials: GH
authors.lastname: Vince
authors.forename: Claudia
authors.initials: C
authors.lastname: Brucker
authors.forename: Peter
authors.initials: P
authors.lastname: Langmann
authors.forename: Christian
authors.initials: C
authors.lastname: Herbold
authors.forename: Laszlo
authors.initials: L
authors.lastname: Solymosi
authors.forename: Klaus
authors.initials: K
authors.lastname: Roosen
mesh_terms: 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
chemical_list: D005938:Glucocorticoids; D011480:Protease Inhibitors; D011804:Quinolines; C508896:sequinavir; D001216:Asparagine; D008775:Methylprednisolone