ABSTRACTS POSTERS WETENSCHAPSDAG SFG 2012 bound similarly to both cell types, suggesting the presence of an alternative binding site, most likely the LDL receptor. Binding of LDL to CR1 could be diminished in a dose response by using heat inactivated serum, which disrupts the function of the complement system, instead of normal human serum. CONCLUSION: This study provides further proof of a protective effect of apoB containing lipoproteins bound to erythrocytes on atherosclerosis. The presence of apoB on erythrocytes can be explained by the capacity of CR1 to bind LDL after opsonisation by complement factors. Immune adherence of apoB-containing lipoproteins to erythrocytes may be operational in vivo. Case report: a spinal epidural abscess. R. Hanewinckel, T. den Heijer, afd. Neurologie. BACKGROUND: A spinal epidural abscess (SEA) is an uncommon condition with an incidence of 0.2 to 2 per 10.0000 hospital admissions per year. Classical symptoms of SEA are spinal pain, fever and neurological deficit. In most cases this triad is not present. Most common complaints are not specific; these include back pain, neck pain and radicular pain. Fever is not always present. For this reason, the diagnosis SEA can be easily overlooked. If not treated early in development, a SEA is a life threatening condition. Therapy of choice is early neurosurgical intervention together with long term antibiotics. In the majority of cases infection is caused by S. Aureus. Choice of antibiotic treatment should be adjusted accordingly. CASE DESCRIPTION: We present a 56-year-old woman who visited the emergency department because she had progressive back pain, radiating into the left leg which started six days before presentation. She also had loss of motor function of the upper leg. Fever was not present, nor were there any other signs of internal or neurologic deficit. Laboratory findings showed highly elevated C-reactive protein (>500 mg/l) and leukocytosis (>20 x 109/l). Imaging studies showed multiple abscesses. There was a spinal epidural abscess ranging from L2-L4, an abscess in the left psoas muscle and in the paravertebral muscles. There was also severe infiltration in both lungs. Puncture of the paravertebral muscle abscess showed infection with Staphylococcus Aureus. The patient was treated with parental flucloxacillin and oral rifampicin together with CT-guided needle aspiration of the psoas muscle abscess. The patient responded very well to this therapy and after two weeks the parenteral antibiotics were replaced by oral clindamycin. The total duration of treatment was seven weeks. CONCLUSION: A spinal epidural abscess is a potentially life threatening condition. Mortality rates are still substantial, because there is a delay in early recognition. Outcome depends mainly on the patient’s neurological status and the duration of symptoms. Therapy of choice is neurosurgical. We presented a patient who was successfully treated with CT guided needle aspiration combined with antimicrobial therapy, without neurosurgical intervention. Een pasgeborene met congenitale anemie. J. van der Weijde, J. van Oossanen, A.K.E. Hoffmann-Haringsma, M.H. Beunis. CASUS: Een jongen geboren bij een amenorroeduur van 39 2/7 week met een geboortegewicht van 3660gram, Apgarscore van 6 en 6 na respectievelijk 1 en 5 minuten met een anemie. Moeder was gravida 3 para 2 met een blanco voorgeschiedenis en een ongecompli119 WETENSCHAPPELIJK jaarverslag 2012 Pagina 118
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