cosyntropin and Hemangioma

In a 35-year old woman presenting familial multiple lipomatosis, spastic paraparesis developed and became worse under tetracosactide therapy. Signs of spinal cord compression at T3 were present. CT and MRI revealed a fat-containing epidural tumour (angiolipoma). The association of angiolipoma with familial multiple lipomatosis has not yet been reported. This association supports the theory that angiolipomas are hamartomatous lesions. The deterioration observed under tetracosactide suggests that iatrogenic epidural lipomatosis is due to the development of a pre-existing lipoma.

Topics: Adult; Cosyntropin; Diagnosis, Differential; Epidural Neoplasms; Female; Hemangioma; Humans; Lipoma; Lipomatosis, Multiple Symmetrical; Magnetic Resonance Imaging; Multiple Sclerosis; Spinal Cord Compression

To determine the prevalence of adrenal insufficiency in infants with hemangiomas following treatment with systemic glucocorticoids (GCs).. Prospective study for 18 months.. Hemangioma and vascular malformation center at a tertiary care children's hospital.. Sixteen infants with hemangiomas had an adrenal axis evaluation as soon as possible following the completion of GC therapy. Ten healthy control infants were also evaluated for comparison.. Prednisolone at a starting dose of 2 to 3 mg/kg/d for 4 weeks, followed by a tapering period. The mean duration of GC treatment was 7.2 months.. Prevalence of adrenal insufficiency in GC-treated subjects as assessed by a combination low-dose/high-dose corticotropin stimulation test.. Subjects underwent corticotropin testing at a mean of 13 days after the completion of therapy. Only 1 of the 16 GC-treated infants (6%) had adrenal insufficiency. This subject was tested 1 day after GC treatment was stopped, and results from retesting 3 months later were normal. All control subjects had normal adrenal function.. Infants with hemangiomas are at low risk of adrenal insufficiency following the completion of GC therapy, as used in our hemangioma center.

Topics: Adrenal Insufficiency; Cosyntropin; Female; Glucocorticoids; Hemangioma; Humans; Hydrocortisone; Hypothalamo-Hypophyseal System; Infant; Male; Pituitary-Adrenal System; Prednisolone; Skin Neoplasms