Skip to main content
Log in

Successful Treatment of an Unusual Case of FPLD2: The Role of Roux-en-Y Gastric Bypass—Case Report and Literature Review

  • Case Report
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Familial partial lipodystrophy type 2 (FPLD2) is a rare disorder associated with LMNA gene mutations. It is usually marked by loss of subcutaneous fat on the limbs and trunk and severe insulin resistance. Scattered reports have indicated that Roux-en-Y bypass helps to control the diabetes mellitus in these patients. We present here a very unusual patient with FPLD2 who had life-threatening retroperitoneal and renal fat accumulation accompanied by bilateral renal cancers. Following cryotherapy of one renal cancer and a contralateral nephrectomy with debulking of the retroperitoneal fat, Roux-en-Y gastric bypass (RYGB) has successfully controlled the disease for 3 years. The clinical presentations and causes of FPLD are reviewed and the role of RYGB is discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Garg A. Clinical review: Lipodystrophies: Genetic and acquired body fat disorders. Journal of Clinical Endocrinology & Metabolism 2011;96:3313–25.

    Article  CAS  Google Scholar 

  2. Farhan SM, Robinson JF, McIntyre AD, Marrosu MG, Ticca AF, Loddo S, Carboni N, Brancati F, Hegele RA. A novel LIPE nonsense mutation found using exome sequencing in siblings with late-onset familial partial lipodystrophy. Can J Cardiol 2014;30:1649–54.

    Article  PubMed  Google Scholar 

  3. Dunnigan M, Cochrane M, Kelly A, Scott J. Familial lipoatrophic diabetes with dominant transmission: A new syndrome. Q J Med 1974;43:33–48.

    CAS  PubMed  Google Scholar 

  4. Köbberling J, Willms B, Kattermann R, Creutzfeldt W. Lipodystrophy of the extremities. A dominantly inherited syndrome associated with lipatrophic diabetes. Humangenetik 1975;29:111–20.

    PubMed  Google Scholar 

  5. Köbberling J, Dunnigan M. Familial partial lipodystrophy: Two types of an X linked dominant syndrome, lethal in the hemizygous state. J Med Genet 1986;23:120–7.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Caron M, Auclair M, Donadille B, Bereziat V, Guerci B, Laville M, Narbonne H, Bodemer C, Lascols O, Capeau J, Vigouroux C. Human lipodystrophies linked to mutations in A-type lamins and to HIV protease inhibitor therapy are both associated with prelamin A accumulation, oxidative stress and premature cellular senescence. Cell Death & Differentiation 2007;14:1759–67.

    Article  CAS  Google Scholar 

  7. Mory PB, Crispim F, Freire MB, Salles JE, Valerio CM, Godoy-Matos AF, Dib SA, Moises RS. Phenotypic diversity in patients with lipodystrophy associated with LMNA mutations. European Journal of Endocrinology 2012;167:423–31.

    Article  CAS  PubMed  Google Scholar 

  8. Ji H, Weatherall P, Adams-Huet B, Garg A. Increased skeletal muscle volume in women with familial partial lipodystrophy, Dunnigan variety. Journal of Clinical Endocrinology & Metabolism 2013;98:E1410–3.

    Article  CAS  Google Scholar 

  9. Simha V, Rao S, Garg A. Prolonged thiazolidinedione therapy does not reverse fat loss in patients with familial partial lipodystrophy, Dunnigan variety. Diabetes Obes Metab 2008;10:1275–6.

    Article  CAS  PubMed  Google Scholar 

  10. Simha V, Subramanyam L, Szczepaniak L, Quittner C, Adams-Huet B, Snell P, Garg A. Comparison of efficacy and safety of leptin replacement therapy in moderately and severely hypoleptinemic patients with familial partial lipodystrophy of the Dunnigan variety. Journal of Clinical Endocrinology & Metabolism 2012;97:785–92.

    Article  CAS  Google Scholar 

  11. McGrath NM, Krishna G. Gastric bypass for insulin resistance due to lipodystrophy. Obesity Surg 2006;16:1542–4.

    Article  Google Scholar 

  12. Utzschneider KM, Trence DL. Effectiveness of gastric bypass surgery in a patient with familial partial lipodystrophy. Diabetes Care 2006;29:1380–2.

    Article  PubMed  Google Scholar 

  13. Ciudin A, Baena-Fustegueras JA, Fort JM, Encabo G, Mesa J, Lecube A. Successful treatment for the Dunnigan-type familial partial lipodystrophy with Roux-en-Y gastric bypass. Clin Endocrinol (Oxf) 2011;75:403–4.

    Article  Google Scholar 

  14. Camozzi D, Capanni C, Cenni V, Mattioli E, Columbaro M, Squarzoni S, Lattanzi G. Diverse lamin-dependent mechanisms interact to control chromatin dynamics. Focus on laminopathies. Nucleus (Calc) 2014;5:427–40.

    Article  Google Scholar 

  15. Guenantin AC, Briand N, Bidault G, Afonso P, Bereziat V, Vatier C, Lascols O, Caron-Debarle M, Capeau J, Vigouroux C. Nuclear envelope-related lipodystrophies. Semin Cell Dev Biol 2014;29:148–57.

    Article  CAS  PubMed  Google Scholar 

  16. Araujo-Vilar D, Lattanzi G, Gonzalez-Mendez B, Costa-Freitas AT, Prieto D, Columbaro M, Mattioli E, Victoria B, Martinez-Sanchez N, Ramazanova A, Fraga M, Beiras A, Forteza J, Dominguez-Gerpe L, Calvo C, Lado-Abeal J. Site-dependent differences in both prelamin A and adipogenic genes in subcutaneous adipose tissue of patients with type 2 familial partial lipodystrophy. J Med Genet 2009;46:40–8.

    Article  CAS  PubMed  Google Scholar 

  17. Haque WA, Vuitch F, Garg A. Post-mortem findings in familial partial lipodystrophy, Dunnigan variety. Diabetic Med 2002;19:1022–5.

    Article  CAS  PubMed  Google Scholar 

  18. Corcelles R, Daigle CR, Schauer PR. Management of endocrine disease: Metabolic effects of bariatric surgery. European Journal of Endocrinology 2016;174:R19–28.

    Article  CAS  PubMed  Google Scholar 

  19. Schauer PR, Bhatt DL, Kirwan JP, Wolski K, Brethauer SA, Navaneethan SD, Aminian A, Pothier CE, Kim ESH, Nissen SE, Kashyap SR, STAMPEDE Investigators. Bariatric surgery versus intensive medical therapy for diabetes—3-year outcomes. N Engl J Med 2014;370:2002–13.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sharon Grundfest-Broniatowski.

Ethics declarations

The authors listed above meet the criteria of the ICMJE. They have made substantial contributions to the conception or design of the work or the acquisition, analysis, and interpretation of data for the work, and/or drafting or revising it critically for important intellectual content. All authors have given final approval of the version to be published and are accountable for all aspects of it.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Grundfest-Broniatowski, S., Yan, J., Kroh, M. et al. Successful Treatment of an Unusual Case of FPLD2: The Role of Roux-en-Y Gastric Bypass—Case Report and Literature Review. J Gastrointest Surg 21, 739–743 (2017). https://doi.org/10.1007/s11605-016-3300-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11605-016-3300-2

Keywords

Navigation