Vertebra Plana in Paediatric Patient with Paraplegia; Diagnostic Approach and Management

Introduction: Vertebra plana is a typical feature of eosinophilic granuloma. But in endemic countries tuberculosis is always a probability especially when there is neurological involvement. Other causes are also to be considered for the appropriate management. Histology sometimes comes inconclusive for which immunohistochemistry helps to reach the diagnosis. Case presentation: We present a case of 12 years old girl with vertebra plana and neurological compromise being treated as tuberculosis outside. We did posterior instrumented fusion with decompression and sent a biopsy. But it failed to give a diagnosis. Later immunohistochemistry proved it to be eosinophilic granuloma. The patient recovered completely to normal neurology. Conclusion: This case demonstrates a rare case of eosinophilic granuloma presenting as vertebra plana and causing neurological deficit. Hence patients should be closely monitored and should undergo decompression at the earliest evidence of neurological compromise. Also it highlights the role of immunohistochemistry in diagnosis.