Case Report

Obesity Surgery

, Volume 18, Issue 2, pp 240-242

First online:

Multiple Benign Symmetric Lipomatosis—A DifferentialDiagnosis of Obesity

Is There a Rationale for Fibrate Treatment?
  • Zeitler HeikeAffiliated withCentre of Extracorporeal Treatment and Lipid Disorders, Medical PoliclinicMedical Policlinic, University of Bonn Email author 
  • , Ulrich-Merzenich GudrunAffiliated withCentre of Extracorporeal Treatment and Lipid Disorders, Medical Policlinic
  • , Richter Dirk FrankAffiliated withDepartment of Plastic Surgery, Dreifaltigkeits Krankenhaus Wesseling
  • , Hans VetterAffiliated withMedical Policlinic, University of Bonn
  • , Peter WalgerAffiliated withMedical Policlinic, University of Bonn

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Abstract

Multiple benign symmetric lipomatosis (MSL) is characterized by a rapid progression of multiple, symmetric nonencapsulated fat masses in face, neck, and extremities. The lipomas are thought to be the result of defective brown adipose tissue (BAT). In up to 90%, MSL is associated with chronic alcohol abuse. Prognosis depends on the concomitant presence of a neuropathy with a mortality of 25.8%. Therapeutic options are limited to alcohol abstinence and surgical interventions. We report here about a 53-year-old MSL patient who increased his body weight by 37 kg over 10 years. Multiple lipectomies were performed but disease progressed. We treated him with fenofibrates (200 mg/day). Disease progression discontinued, and circumferences of abdominal adipose tissue reduced. Fibrates, peroxisome proliferator-activated receptor alpha agonists, are pleiotropic hypolipidemic drugs and might have worked by suppression of protein expressions involved in the architecture of BAT keeping it in a quiescent state.

Keywords

Benign symmetric lipomatosis Triglycerides Fibrates Alcoholism Overweight Surgery Medical treatment Liposuction