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Congresso Internacional de Neurocirurgia-Congreso Internacional de Neurocirugía. Neuroiberia 2016
Portugal, 11-14 mayo 2016
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22. COLUNA - RAQUIS - SPINE
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P187 - ASSOCIATION BETWEEN WEGENER'S GRANULOMATOSIS AND SE-VERE LUMBAR PAIN

N. Nunes Rabelo1, N. Nunes Rabelo1, R. Pontes Sader2, A.C. Cunha da Câmara Ramos1 and K. Tanaka1

1
Department of Neurosurgery, Santa Casa de Misericórdia, Ribeirão Preto Hospital. 2Centro Universitário Barão de Mauá, Ribeirão Preto, São Paulo, Brazil

Introduction: Wegener’s granulomatosis (WG) is a systemic autoimmune disease characterized by necrotizing granulomatous vasculitis which primarily affects upper respiratory tract, lungs and kidneys. However, less frequently can affect muscles, joints, skin, eyes, cardiovascular system and nervous system. The presence of lumbar pain consists in an unusual clinical manifestation due to the involvement of the nervous system.

Objectives: The objective of this study is to alert health professionals about the possibility to sever lumbar pain be related to Wegener’s granulomatosis, its impact on the patient’s daily life as well as clinical signs and diagnosis forms.

Material and methods: Literature review using PubMed, Medline, Google Scholar, SciELO, EBSCO. Selected works from 1995 to 2013 totaling 48 works of which 21 were selected according to their reports of neurological involvement, diagnosis and treatment. Neurological symptoms may occur in 22-50% of patients during the course of WG. Central nervous system (CNS) involvement is uncommon (only 2-8% of patients). Severe lumbar pain is a rare clinic manifestation and it can be associated with the involvement of central and peripheral nervous system. CNS due to compression of the spinal cord at the lumbar level. Peripheral nervous system due to compression of nerve roots.

Conclusions: Wegener’s granulomatosis for being a systemic disease can present different clinical manifestations according to the involved site. It’s associations with lumbar pain is rare and reflects its neurological involvement. Therefore, in patients with severe lumbar pain without confirmed diagnosis, Wegener’s granulomatosis should be considered.

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