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Diagnosis of generalized lipodystrophy
Last reviewed: 23.04.2024
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The diagnosis of generalized lipodystrophy syndrome is established on the basis of the characteristic appearance of patients (total absence of subcutaneous fat or specific redistribution of the latter with excessive development in the face and neck and disappearance on the trunk and extremities, skeletal muscle hypertrophy, signs of acromegaly, hypertrichosis) and complaints of headache, pain and heaviness in the right hypochondrium, menstrual irregularities, hirsutism.
Differential diagnostics
Syndrome of generalized lipodystrophy in some cases has to be differentiated from Itsenko-Cushing disease, acromegaly, insulinoma, decompensated insulin-dependent diabetes mellitus.
In contrast to disease, Itsenko-Cushing's disease, with the syndrome of generalized lipodystrophy, there are no characteristic changes in the skin, striae; no atrophy of skeletal muscles on the limbs, fat deposits in the abdomen, osteoporosis.
Differentiating the syndrome of generalized lipodystrophy with acromegaly is sometimes difficult. However, prognathism and hypertrophy of the bones of the skeleton in the syndrome of generalized lipodystrophy never reach such a degree as in acromegaly. In addition, the blood levels of STH in generalized lipodystrophy syndrome are always within normal limits.
Against insulinomas in the clinical picture of the syndrome of generalized lipodystrophy say the absence of the characteristic hypoglycemic coma and obesity.
When differentiating the syndrome of generalized lipodystrophy and insulin-dependent decompensated diabetes, one should pay attention to the absence of clinical manifestations of ketoacidosis in patients with no subcutaneous fatty tissue.
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