Abstract
IntroductionTo date, lumbar disc herniation has not been reported in the context of cystic fibrosis even though back pain and musculoskeletal problems are very common in patients with cystic fibrosis.Case presentationWe report on three patients with cystic fibrosis who experienced lumbar disc herniation in the course of their disease at ages 19 to 21 years (a 22-year-old Caucasian man, a 23-year-old Caucasian man, and a 21-year-old Caucasian woman). Our third patient eventually died because of her deteriorated pulmonary situation, which was influenced by the lumbar disc herniation as it was not possible for her to perform pulmonary drainage techniques properly because of the pain.ConclusionsLumbar disc herniation can lead to a vicious cycle for patients with cystic fibrosis as it may promote pulmonary infections. This report highlights the need to investigate patients correctly.
Highlights
To date, lumbar disc herniation has not been reported in the context of cystic fibrosis even though back pain and musculoskeletal problems are very common in patients with cystic fibrosis.Case presentation: We report on three patients with cystic fibrosis who experienced lumbar disc herniation in the course of their disease at ages 19 to 21 years (a 22-year-old Caucasian man, a 23-year-old Caucasian man, and a 21-year-old Caucasian woman)
Whereas many papers focus on pain in patients with Cystic fibrosis (CF), studies on lumbar disc herniation (LDH) in patients with CF have not been reported to date [7]
Case presentation We report on three patients with clinically symptomatic and radiologically proven LDH from our CF clinic
Summary
Cystic fibrosis (CF) is a lethal chronic pulmonary disease with recurrent acute infective exacerbations, inevitably leading to progressive bronchiectasis and combined ventilatory disorders [1]. Case 1 Patient 1 was a 22-year-old athletic and muscular Caucasian man (delta F 508 homozygous, Pseudomonas positive) with good lung function parameters (Table 1), in whom LDH was diagnosed at an age of 21 years. He had experienced recurrent back pain, predominantly lumbalgia, for about two years before the diagnosis of LDH. Our patient died eight months after LDH diagnosis while on the high urgency waiting list for lung transplantation because of an unmanageable pulmonary infection with massive pulmonary bleeding She had spent three weeks on extracorporeal membrane oxygenation (ECMO) before she died. The fact that she temporarily fell from the high urgency list a month before her death because of improving partial CO2 values on blood gas analysis may have played a role in the disease process, as it tremendously destabilized her mood and raised fears she may not get a transplant organ
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