Lipedema syndrome, painful E88.8

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

back leg of a healthy woman; Column leg; Fat bone; Fat syndrome painful; Lipedema; Lipidosis; painful fat syndrome; Painful fat syndrome; Painful fatty syndrome; Painful lipedema syndrome of the lower legs; zonal obesity

History
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Allen and Hines, 1940

Definition
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Clinical syndrome characterized by proliferation of subcutaneous fatty tissue and orthostatic leg edema, accompanied by a fat distribution disorder, especially in the thighs and lower legs.

Etiopathogenesis
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Unclear; family disposition is described. The disease seems to start with an increased capillary filtration through the loose fatty tissue structure. Edema formation leads to secondary occlusion of capillary vessels with reduction of lymph transport.

Manifestation
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Usually begins after puberty. Women are about 100 times more frequently affected than men.

Localization
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Hips, thighs and lower legs, feet usually free.

Clinical features
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Symmetrical, coarse, indentable swelling of the legs, which increases with prolonged orthostatic load, with diffuse pain or pain due to pressure, especially in the area of the tibial crest. Supramalleolar collar (fat muff). Typical are swollen thighs and lower legs with slender feet!

Laboratory
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Occasionally hyperlipoproteinemia.

Differential diagnosis
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Therapy
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Manual lymphatic drainage or intermittent compression therapy using equipment (e.g. lymphatic mat or hydroven), depending on the lymphedema. Compression stockings as permanent treatment.

Progression/forecast
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Slowly progressive course.

Literature
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  1. Allen EV, Hines EA (1940) Lipedema of the legs. Proc. Mayo Clin 15: 184-187
  2. Hines EA, Allen EV (1951) Lipedema of legs: a syndrome characterized by fat legs and oedema. Ann Intern Med (Philadelphia) 34: 1243-1250
  3. Macdonald JM et al (2003) Lymphedema, lipedema, and the open wound: the role of compression therapy. Surg Clin North Am 83: 639-658
  4. Monnin-Delhom ED et al (2002) High resolution unenhanced computed tomography in patients with swollen legs. Lymphology 35: 121-128
  5. Tiwari A et al (2003) Differential diagnosis, investigation, and current treatment of lower limb lymphedema. Arch Surgery 138: 152-161
  6. Wienert V et al (1991) The lipedema. dermatologist 42: 484-486

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

Authors

Last updated on: 29.10.2020