Acquired Lipodystrophy: Causes, Symptoms, Complications, And Treatment

Lipodystrophy can be described as a head term of a group of medical conditions that can be diagnosed as partial or complete loss of adipose tissue. Adipose tissue is the one that stores fat in your body so in layman terms lipodystrophy is a disease that manipulates your ability to store fat. Lipodystrophy can be categorized into 4 types. Each type is different based on affected areas, severity, and duration.

1. Acquired Generalized Lipodystrophy: AGL is also Lawrence syndrome. This type of lipodystrophy mostly affects the arms, legs, neck, and face. In rare cases, loss of fat can also happen to bone marrow and Intra-abdominal fat. This generally started during childhood or adolescence but it is not mandatory.

   The nature of lipodystrophy can be both slow or fast in its development. It can lead to a life-threatening situation as complete loss of fat veins bulging and muscular appearance from underneath the skin. AGL can further be divided into three subtypes:

   • Panniculitis-associated AGL
   • Autoimmune-associated AGL
   • AGL of unknown cause (idiopathic)
2. Acquired Partial Lipodystrophy: APL was also known by the name of Barraquer-Simons Syndrome. Patients often lose face fat which can also extend to the neck, arms, chest, and upper abdomen. It does not affect your hips, legs, and thighs, in rare cases, an individual puberty can trigger disproportionately that is, excess fat accumulation in the hips and legs region of the body.

   This form of Lipodystrophy usually started to show its effects during childhood. One might experience it at a small age, however, at the time of birth and during early childhood, it does not show its effects.

3. High Active Antiretroviral Therapy (HAART) or Induced Lipodystrophy (Ld-Hiv): Lipodystrophy of this form is generally caused by immunodeficiency virus (HIV) antiretroviral therapy known as HIV-1 protease inhibitor-containing HAART. Common in patients where the therapy has already taken place for more than 2 years straight. The intensity of this form depends on the individual cases and their inheritance in their body.
4. Localized Lipodystrophy: In this type, the subcutaneous fat loss belongs to tiny sections of the body. It is rare but this can also be contiguous or spread through larger parts of the body.

Summary: Lipodystrophy is a disease that manipulates your ability to store fat. Lipodystrophy is usually of 4 types. Each type is different based on affected areas, severity, and duration.

The symptoms of acquired lipodystrophy can be different in the case of each individual type. Loss of subcutaneous fat is a common sign in each individual category. Apart from that here are the list of symptoms that can help you identify the presence:

Symptoms of ALG:

• Loss of subcutaneous fat from the face, neck, arms, and legs.
• FatigueHypertriglyceridemia.
• Diabetes.
• Pancreatitis.
• Polycystic ovary syndrome (PCOS).
• Severe insulin resistance.
• Autoimmune hepatitis.
• Hypertriglyceridemia.
• Chylomicronemia.
• Glucose intolerance.
• Acanthosis nigricans (group of disease composed through the development of hyperpigmentation, hyperkeratosis, axillae).
• Hepatomegaly can also lead to hepatic steatosis, cirrhosis, or fatty liver.

Symptoms Of Acquired Partial Lipodystrophy:

• Membranoproliferative glomerulonephritis (a form of kidney disorder)
• Glomerulonephritis
• Drusen
• Macular degeneration
• Lupus
• Insulin resistance
• Hepatomegaly
• Dermatomyositis
• Celiac disease
• Pernicious anaemia
• Vasculitis

Symptoms of Induced Lipodystrophy (Ld-Hiv):

• Hypertriglyceridemia.
• Double chin.
• Lose subcutaneous fat from the arms, legs, face,upper back, and waist.
• Diabetes.
• The hump on the upper back.
• Coronary heart disease.

Symptoms of Localized Lipodystrophy:

• Insulin injection.
• Loss of subcutaneous fat from chin.

Summary: The symptoms of acquired lipodystrophy can be different in the case of each individual type. Loss of subcutaneous fat is a common sign in each individual category.

There is no specific reason why Acquired lipodystrophies happen. Researchers around the globe are brainstorming about reasons, some of them were medication, autoimmune reactions, or having a genetic predisposition to developing certain forms of acquired lipodystrophy. The root cause can be one or many, it depends on each case.

In the case of ALG, infections and autoimmune diseases are the known culprit, so here are some of them that can be the reason behind acquired lipodystrophy:

• Pneumonia
• Measles
• Varicella
• Autoimmune thyroiditis
• Juvenile dermatomyositis
• Rheumatoid arthritis
• Autoimmune hemolytic anaemia
• Diphtheria
• Autoimmune hepatitis
• Infectious mononucleosis
• Parotitis
• Sjogren’s syndrome
• Osteomyelitis
• Sicca syndrome
• Pertussis

In the case of AGL autoimmune disorders are associated with the deficiency of complement 4, a protein factor responsible for the body’s immune system response.

APL on the other hand can be caused by an immune system malfunction known as autoimmune-mediated destruction of adipocytes. Also in the case of APL, patients have found a heavy scarcity of complement 3 and an increase of complement 3-nephritic factor.

Summary: The actual cause behind developing Acquired lipodystrophies is not known. happen. However, some elements like autoimmune reactions, medications, or genetic predisposition of specifically acquired lipodystrophy.

The nature of the disease can also be examined via assisting an individual physical state, your doctor will check your condition for characteristic symptoms, and medical history. Then the next step will be a general physical examination and diagnosis through specialized tests.

In the case of AGL, your doctor may look for a generalized lack of subcutaneous fat and the overall muscular appearance of the patient. Also, many doctors suspect that the presence of panniculitis preceding and autoimmune disease preceding can also tell us the presence of AGL.

In the case of APL, progressive loss of upper body fat that spares the lower body can be the clue. It is mostly seen in adolescents around the age of 16.

Apart from general examinations here is the list of tests that your doctor may ask you to do for diagnosis accuracy:

• Blood tests check your glucose, lipids, liver enzymes, and uric acid.
• Serum C3, C1 and C4 levels.
• Presence of autoantibody C3NeF.
• Magnetic resonance imaging (MRI).
• Renal biopsy.
• Microscopic examination of kidney tissue.

Summary: The actual diagnosis process will require a patient's physical state examination, characteristic symptoms, and medical history. Then the next step will be a general physical examination and diagnosis through specialized tests.

Since the cause of the disease is not researched to the conclusion, Acquired Lipodystrophy is hard to prevent in an individual. Also, most of the researchers and studies found pointed out it is an autoimmune disease, which also makes the medical condition hard to prevent.

Summary: It is quite difficult to prevent Acquired Lipodystrophy is still under research.

If you see any symptoms in you or your child. Contact your medical supervisor immediately.

Summary: Immediately seek medical help if you witness any sign or symptom related to it in the person.

Diseases like Acquired Lipodystrophy do not go away on their own. It can cause a critical life situation if not treated on time.

There is no specific treatment plan designed to treat this medical condition. However, many treatments focusing on each problem are generally recommended. The treatment may include many healthcare professionals like pediatricians, plastic surgeons, cardiologists, endocrinologists, and nutritionists.

1. Medications: your doctor will prescribe fibric acid derivatives, statins, or n-3 polyunsaturated fatty acids supplementation from fish oils to regain the fat loss. In the case of diabetes, one may ask to get diabetes treatment including insulin alongside medication like metformin, sulfonylureas, and thiazolidinediones.
2. Surgery: Since the disease does not go away and its treatment is still under research, doctors prefer to have cosmetic surgery that may help in both improving appearance and managing metabolic complications. In case of liver damage, one has to undergo liver transplantation.
3. Therapies: therapies like liposuction ( to even the fat content), leptin-replacement therapy ( to maintain leptin deficiency), and Metreleptin therapy ( to neutralize anti-leptin antibodies, and lymphomas) is recommended to ease out acquired lipodystrophies.
4. Counseling: in situations like this one may feel stressed and anxious because of the prolonged treatment, frequent testing, and financial pressure. Your doctor will ask you to consult a group or any psychological support/counseling. Genetic counseling is also recommended to the families of the patients to look for any link or risk in their adults or offspring.

Summary: There is no specific treatment plan designed to treat this medical condition. However, according to each problem, there are certain general treatments available.

To reign in the optimum body energy and fat your doctor will ask you to have a high carbohydrate, low-fat diet to lower the risk of acute pancreatitis. You can also have fish oil capsules but on the doctor’s advice.

There is no specific diet designed for Acquired Lipodystrophy. However, you can ask your medical professional if there is any specific food that you need to avoid during treatment.

The side effects of the treatment may depend on the type of medication your doctor prescribed you alongside the treatment that your doctor is using to treat the medical condition.

Summary: The treatment has side effects only when the prescribed limit is crossing or the treatment given is not right. Also, it depends upon person to person’s health condition.

Yes, if the surface symptoms match, contact your nearest medical aid on an urgent basis.

Summary: When the situation gets critical or you notice any symptom related to Acquired Lipodystrophy, then it is better to consult the doctor than to be late.

The treatment of the disease merely depends on each case and the method of treatment that has been selected to do so.

Summary: Recovery of the patient depends upon the current health condition and the treatment given.

The price of the whole treatment depends on each procedure. Medication, counseling, can cost you around 1000 to 10,000 rupees while therapies and surgery can cost you around 5 - 7 lakhs per session.

Summary: The price of the treatment depends on the procedure you are opting for. This includes everything right from medication to surgical procedures and doctor’s consultations.

Regular exercise and maintaining a healthy weight decrease your chances of developing diabetes. In individuals with acquired lipodystrophy, avoiding exercise can be beneficial. As it allows the lipodysed area to gain fat.

Summary: It is better not to do exercise if a person is suffering from acquired lipodystrophy. It maintains a healthy weight and decreases your chances of developing diabetes.

Your doctor will prescribe n-3 polyunsaturated fatty acids, statins, or fibric acid derivatives supplementation from fish oils to regain the fat loss. In the case of diabetes, one may ask to get diabetes treatment including insulin alongside medication like metformin, sulfonylureas, and thiazolidinediones.

Summary: Your doctor will prescribe medications to relieve the symptoms as well as to control or manage the fat in your whole body.

No, the results of the treatment are not permanent; one may relapse if the treatment is postponed or eliminated at any point in time in your life.

Summary: In case a person has postponed or delayed the treatment, then there are higher chances of developing Acquired Lipodystrophy.

Since there is no specific treatment plan available, your doctor will make one based on your existing symptoms. So there is no alternative present at the current moment.

Summary: You need to consult the doctor for alternative treatment. It depends upon your existing health condition.

People who are suffering from Acquired Lipodystrophy are eligible for the treatment. Also, people with the same set of symptoms mentioned above can consult a doctor for diagnosis and treatment plans.

People who are not suffering from Acquired Lipodystrophy are not eligible for the treatment.

Since there is no cure for the disease the treatment of Acquired Lipodystrophy will go as long as the person survives.

Summary: Acquired Lipodystrophy is a partial or complete loss of adipose tissue. It is further categorized into 4 types. As of now, there is no cure for this disease available. But there are several treatments that are effective in treating different symptoms of this disease. The treatment can only ensure relief from the discomfort and its associated life threats.