Autopsy in a Case of Adiposis Dolorosa

Debcum, F. X.; Dj, McCarthy

doi:10.1097/00000441-190212000-00006

Cited by 33 publications

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“…Most often, the microscopic diagnosis fails to reveal any changes to account for the dolorous nature of the disease. Dercum found connective tissue infiltration around the nerves in fatty deposits and assumed the pain was due to a neuritis 14 . However, none of our patient's multiple specimens revealed such changes, nor have such findings been noted by others since Dercum.…”

Section: Discussioncontrasting

confidence: 42%

Surgical Amelioration of Dercum's Disease: A Report and Review

Held

Andrew

Kohn

1989

The Journal of Dermatologic Surgery and Oncology

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Dercum's disease, or adiposis dolorosa, is a rare condition characterized by painful lipomas, usually on the extremities of obese postmenopausal women. At present, there are no treatments known to alter the progressive course of this often incapacitating disease. Surgical intervention, while not preventive, is useful in ameliorating local symptoms of pain. We report a characteristic 15-year course of Dercum's disease.

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Section: Discussioncontrasting

confidence: 42%

Surgical Amelioration of Dercum's Disease: A Report and Review

Held

Andrew

Kohn

1989

The Journal of Dermatologic Surgery and Oncology

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“…6 Fourteen respondents (11.8%), including 42% of the men, had growths and symptoms as children. 2 In support, the majority of women answering our survey developed AD while menstruating and before age 48 years, less than the average age of menopause expected for this population. 2 In support, the majority of women answering our survey developed AD while menstruating and before age 48 years, less than the average age of menopause expected for this population.…”

Section: Discussionmentioning

confidence: 48%

“…1,2 The onset of AD is insidious and progressive, associated pain and fatigue disabling, 3,4 and pain unresponsive to analgesics. 1,2 The onset of AD is insidious and progressive, associated pain and fatigue disabling, 3,4 and pain unresponsive to analgesics.…”

Section: Learning Objectivesmentioning

confidence: 99%

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Adiposis Dolorosa Is More Than Painful Fat

Herbst¹,

Asare-Bediako²

2007

The Endocrinologist

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Objective: To describe signs and symptoms of adiposis dolorosa (AD) in a large cohort of individuals with this disorder to increase recognition, diagnosis, and research of this syndrome. Design: Survey. Subjects: One hundred ten men and women with AD. Measurements: The survey included questions on demographics, obesity, signs and symptoms in soft tissues and body systems, susceptibility to infection, diet, treatments and lifestyles, medical and family history, habits, and exercise. Results: Subjects were white, non-Hispanic except for 3 Hispanics and 2 African Americans, and mostly women (82.7%) of northern European ancestry living in the United States (87.3%), average age 48.5 Ϯ 10 years. The majority of respondents were obese, bodymass index of 34.7 Ϯ 8.7 kg/m 2 and had AD for 14.5 Ϯ 11.9 years. Onset of growths began primarily in the arm or leg at a mean age of 34.5 Ϯ 12.8 years (range, 7-67 years). The majority reported pain, fatigue, weight gain (25.7 Ϯ 15 kg), multiple growths, and weakness at onset. The median number of palpable growths was 77.3 Ϯ 84.5 in subcutaneous fat from scalp to dorsal foot. Growths ranged from firm and pea-sized to large, fixed, and deep. Pathology descriptions of growths included lipoma, fibrolipoma, or angiolipomas. Autoimmune disease and fibromyalgia were prominent (38.2%), as was diabetes (16.4%). Almost all respondents reported exercise-associated pain in growths, and 100% saw no decrease in growths with weight loss. Over 75% had liposuction and over half reported regrowth. Almost half reported family members with growths. Conclusion: Our survey results suggest AD is a painful syndrome involving growths in all subcutaneous fat. It can be inherited or sporadic, beginning in the third decade of life, but can occur in children and is accompanied by obesity, fatigue, joint and muscle aches, and other signs and symptoms affecting multiple organ systems. Exercise induces pain and has no effect on fatty growth size. The etiology of this syndrome remains unknown.

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“…The early reports of Dercum's syndrome noted variable pathology in endocrine glands at necropsy (Dercum, 1892;Dercum and McCarthy, 1902;Price, 1909;Winkelman and Eckel, 1925). The evidence for a pluriglandular involvement was later doubted (Steiger et al, 1952).…”

Section: Discussionmentioning

confidence: 99%

Juxta-articular adiposis dolorosa: what is it? Report of 2 cases.

Eisman¹,

Swezey²

1979

Annals of the Rheumatic Diseases

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suMMARY Juxta-articular adiposis dolorosa may be defined as the localised accumulation of painful fat near joints, most commonly the knee. It exists as a separate entity that must be distinguished from other causes of knee pain. We present 2 patients with this condition and review the literature. Various approaches to therapy are discussed. A classification of painful fat near joints is proposed.Juxta-articular adiposis dolorosa (JAD)-does it exist? What is it? Literally it means painful fat near a joint. We believe the condition does exist as a separate entity and that it may coexist with other disorders affecting joints. We describe 2 patients with this disorder and review the available literature. It is important to recognise the condition as a not so rare cause of knee pain. Nevertheless we have been unable to find a single publication about this disorder in the rheumatology journals and reviews. A classification of painful fat in and around joints is proposed, and various pharmacological and physiotherapeutic measures are discussed. effusion. Just medial to each knee was a fist-sized mass of rather tense and extremely tender fatty tissue. There was also tenderness of both pes anserine bursae.Investigations revealed a normal complete blood count, differential white cell count, and erythrocyte sedimentation rate. Biochemical tests were normal except for a serum calcium of 11 2 mg/dl, serum phosphorus of 2 * 3 mg/dl, and a serum parathyroid hormone level of 109 ,tlEq/ml (normal 90-100) (at the time of writing no disposition of her hyperparathyroidism has been made). Thyroid function tests, glucose tolerance test, RA latex, ANA, serum uric acid, and an electromyogram of both lower limits were normal or negative. Roentgenograms (including weight-bearing views) of both knees were also normal. A fat biopsy from the mass on the left knee was also normal.A diagnosis of JAD was made. She was treated with aspirin, naproxen, indomethacin, and ibuprofen in full anti-inflammatory doses. None of the nonsteroidal agents relieved her pain. A course of carbamazepine (given elsewhere) was also without benefit. Local injection (of the painful fat) with lignocaine exacerbated her symptoms. Injection of the left anserine bursa with triamcinolone acetonide suspension and lignocaine was ineffective, and attempts at weight reduction were also unsuccessful. A trial of corrective shoes with medially wedged soles and heels in an effort to minimise valgus angulation and medial knee contact gave no relief. Finally, intermittent pneumatic compression (Jobst) was used in an attempt to compress the fat and possibly mobilise suspected local oedematous accumulations in fatty tissue. The patient was able to tolerate 65 mmHg of pressure for 1 hour twice daily, but when the pressure was increased to 70 mmHg 479 on 11 May 2018 by guest. Protected by copyright.

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Autopsy in a Case of Adiposis Dolorosa

Cited by 33 publications

References 0 publications

Surgical Amelioration of Dercum's Disease: A Report and Review

Surgical Amelioration of Dercum's Disease: A Report and Review

Adiposis Dolorosa Is More Than Painful Fat

Juxta-articular adiposis dolorosa: what is it? Report of 2 cases.

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