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(Localized lipodystrophy: insulin injection, corticosteroid injection)
Two syndromes characterized by loss of subcutaneous fat:
Partial lipodystrophy:
| • | the more common of the 2 syndromes |
| • | poorly understood disorder (autoimmune?) |
clinical:
| • | over several years, gradually lose their subcutaneous fat |
| • | wasting usually begins on face and spreads downward |
| • | may stop at any level, most often above or at level of mid-thighs (“cephalothoracic type” = most common) |
epidemiology:
| • | develops in most patients before the age of 15 |
labs:
| • | patients frequently have hypertriglyceridemia and insulin resistance (clinical DM develops in ~ 20%) |
| • | decreased serum complement (C3) = most common lab abnormality |
| • | many PL patients have glomerulonephritis, but percentage who eventually develop significant renal disease not known |
Generalized lipodystrophy:
| • | condition may be congenital or acquired later in life |
| • | syndrome often termed “lipoatrophic diabetes “ |
| • | clinical – patients lack both subcutaneous fat and extracutaneous adipose tissue |
| • | lab – decreased glucose tolerance = characteristic |
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