ECE2016 Eposter Presentations Clinical case reports - Thyroid/Others (71 abstracts)
A novel clinical phenotype of acquired partial lipodystrophy associated with intensive childhood cytostatic treatment
Michiel Nijhoff 1, , Eleonora Corssmit 1 , Marloes Louwerens 3 , Ingrid Jazet 3 & Alberto Pereira 1
1LUMC, Department of Internal Medicine, Division of Endocrinology, Leiden, The Netherlands; 2LUMC, Department of Internal Medicine, Division of Nephrology and Transplantation, Leiden, The Netherlands; 3LUMC, Department of Internal Medicine, Leiden, The Netherlands.
Context: Lipodystrophy is characterized by subcutaneous fat loss, fat maldistribution, and metabolic syndrome. We present a novel phenotype of partial acquired lipodystrophy, possibly associated with childhood chemotherapy.
Case reports: Two adult female patients that had been exposed to intensive cytostatic treatment in childhood for leukemia and aplastic anemia, respectively, were referred for therapy resistant diabetes. Both patients had distinct partial lipodystrophy at the hips and distal extremities with severe hypertension, insulin resistance, dyslipidemia, and steatohepatitis. BMI was normal. Leptin levels were increased in both patients without evidence for auto-immunity or known pathogenic DNA mutations. Pioglitazone treatment reversed all features of the metabolic syndrome in the first patient. Pioglitazone could not be initiated in the second patient due to myocardial ischemia.
Conclusion: Lipodystrophy may be associated with intensive cytostatic treatment in childhood, since this phenotype, characterized by loss of fat tissue of the extremities and buttocks in the presence of elevated (instead of low) leptin levels, did not match previously reported types of lipodystrophy. As the number of patients that survive childhood cancer increases, this association might well become relevant.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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