Progressive Epidural Lipomatosis with Steroid use in Severe Refractory Asthma

Abstract

Background. Long-term immunosuppression with oral corticosteroids is frequently used to treat inflammatory diseases of the lung and is advocated in the management of some patients with asthma. Methods. The authors describe the case of a 35-year-old man with severe refractory asthma who developed a slowly progressive thoracic spinal cord syndrome. Results. Spinal imaging demonstrated the presence of spinal epidural lipomatosis, a rare complication of prolonged corticosteroid therapy, which is characterized by overgrowth of fat in the epidural space and neuronal compression. Conclusions. Spinal epidural lipomatosis should be considered in patients receiving long-term corticosteroid therapy who develop symptoms and signs suggestive of spinal cord compression.