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Diagnosis of generalized lipodystrophy
Last reviewed: 04.07.2025
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The diagnosis of generalized lipodystrophy syndrome is established based on the characteristic appearance of patients (complete absence of subcutaneous fat or its specific redistribution with excessive development in the face and neck area and disappearance on the trunk and limbs, hypertrophy of skeletal muscles, signs of acromegaly, hypertrichosis) and complaints of headache, pain and heaviness in the right hypochondrium, menstrual irregularities, hirsutism.
Differential diagnostics
In some cases, generalized lipodystrophy syndrome must be differentiated from Itsenko-Cushing's disease, acromegaly, insulinoma, and decompensated insulin-dependent diabetes mellitus.
Unlike Itsenko-Cushing's disease, generalized lipodystrophy syndrome does not have characteristic skin changes, striae; there is no atrophy of skeletal muscles in the limbs, fat deposits in the abdominal area, or osteoporosis.
Differentiating generalized lipodystrophy syndrome from acromegaly is sometimes difficult. However, prognathism and hypertrophy of the skeletal bones in generalized lipodystrophy syndrome never reach the same degree as in acromegaly. In addition, the content of STH in the blood in generalized lipodystrophy syndrome is always within normal limits.
The absence of characteristic hypoglycemic comatose states and obesity speaks against insulinoma in the clinical picture of generalized lipodystrophy syndrome.
When differentiating between generalized lipodystrophy syndrome and insulin-dependent decompensated diabetes, attention should be paid to the absence of clinical manifestations of ketoacidosis in patients against the background of the absence of subcutaneous fat.
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