Nesreen Jaafar1, Maria Khoueiry1, Samia J Khoury2, Achraf Makki1. 1. Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon. 2. Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon.
Abstract
INTRODUCTION: Spinal neurosarcoidosis is a rare disease that can manifest as myelopathy, radiculopathy, or cauda equine syndrome. Spinal epidural lipomatosis is also a rare condition resulting from overgrowth of epidural fat tissue causing compressive myelopathy. To our knowledge, there are no reports linking epidural lipomatosis and spinal neurosarcoidosis. Case Report. We describe a case of progressive myelitis in the presence of concomitant spinal neurosarcoidosis and epidural lipomatosis which was a challenging diagnosis with complete response to treatment after addressing both diseases. Both etiologies are inflammatory in nature and share similar expression of inflammatory factors such as TNF-α and IL-1β. CONCLUSION: The common inflammatory process involved in these two diseases might explain a pathophysiological interconnection between both diseases that may underlie their concomitant development in our patient. If these two diseases are interconnected, in their pathophysiological mechanism remains a hypothesis that will need further investigation.
INTRODUCTION: Spinal neurosarcoidosis is a rare disease that can manifest as myelopathy, radiculopathy, or cauda equine syndrome. Spinal epidural lipomatosis is also a rare condition resulting from overgrowth of epidural fat tissue causing compressive myelopathy. To our knowledge, there are no reports linking epidural lipomatosis and spinal neurosarcoidosis. Case Report. We describe a case of progressive myelitis in the presence of concomitant spinal neurosarcoidosis and epidural lipomatosis which was a challenging diagnosis with complete response to treatment after addressing both diseases. Both etiologies are inflammatory in nature and share similar expression of inflammatory factors such as TNF-α and IL-1β. CONCLUSION: The common inflammatory process involved in these two diseases might explain a pathophysiological interconnection between both diseases that may underlie their concomitant development in our patient. If these two diseases are interconnected, in their pathophysiological mechanism remains a hypothesis that will need further investigation.
Authors: M Steffen; J Petersen; M Oldigs; A Karmeier; H Magnussen; H G Thiele; A Raedler Journal: J Allergy Clin Immunol Date: 1993-04 Impact factor: 10.793
Authors: Itay Lotan; Robert W Charlson; Girish M Fatterpekar; Maksim Shapiro; Michael L Smith; Christopher William; Ilya Kister Journal: J Neurol Sci Date: 2020-01-16 Impact factor: 3.181
Authors: J P Zajicek; N J Scolding; O Foster; M Rovaris; J Evanson; I F Moseley; J W Scadding; E J Thompson; V Chamoun; D H Miller; W I McDonald; D Mitchell Journal: QJM Date: 1999-02