A Case of Crowned Dens Syndrome Successfully Treated with Kampo Medicine / 日本東洋医学雑誌

ABSTRACT

Crowned dens syndrome is a type of pseudogout that occurs in the elderly. It is associated with calcification around the dens of the atlas and can cause recurrent pain. We report successful treatment for crowned dens syndrome by using Kampo medicine. An 85-year-old woman was seen in our clinic after 3 days of neck pain and active exercise pain without trigger. Physical examination revealed tenderness in the bilateral upper cervical spine. Computed tomography (CT) revealed calcifications around the dens of the atlas and blood test data showed inflammatory reaction. Thus, she was diagnosed with crowned dens syndrome. In view of her medical history of gastric ulcer treatment, we prescribed Kampo medicine eppikajutsuto and daiobotampito, instead of nonsteroidal antiinflammatory drugs. The cervical pain and tenderness in her bilateral upper cervical spine disappeared, and her laboratory data also improved 6 days after treatment without side effects. Thus, her medications were discontinued.