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Journal ArticleDOI

Lipedema: an overview of its clinical manifestations, diagnosis and treatment of the disproportional fatty deposition syndrome - systematic review.

TL;DR: Early diagnosis and treatment are mandatory for this disorder otherwise gradual enlargement of fatty deposition causes impaired mobility and further comorbidities like arthrosis and lymphatic insufficiency.
Abstract: Lipedema is a disproportionate, symmetrical fatty swelling characterized by pain and bruising existing almost exclusively among women. We undertook a systematic review of the available literature about lipedema, given the lack of knowledge and little evidence about this disorder especially among obesity experts. Diagnosis of lipedema is usually based on clinical features. Symmetrical edema in the lower limbs with fatty deposits located to hips and thighs usually appears at puberty and often affects several members of the same family. Main disorders considered for differential diagnosis are lymphedema, obesity, lipohypertrophy and phlebedema. Treatment protocols comprise conservative (decongestive lymphatic therapy) and surgical (liposuction) approaches. Early diagnosis and treatment are mandatory for this disorder otherwise gradual enlargement of fatty deposition causes impaired mobility and further comorbidities like arthrosis and lymphatic insufficiency.

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Citations
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Journal ArticleDOI
TL;DR: The authors presented lipoedema as a social problem and found that more than 3/4 of patients with lipoboxema are overweight or obese, and their presence negatively affects the quality of life.
Abstract: (1) Background: Lipoedema is a disease characterized by excessive bilateral and symmetrical accumulation of subcutaneous tissue in the lower extremities. It is a poorly understood condition, and low awareness of its existence often leads to incorrect diagnosis Initially, lipoedema was considered to be completely independent of lifestyle Currently, however, more and more cases of the coexistence of lipoedema and obesity are described in the literature as additionally affecting the severity of the disease The aim of the review is to present lipoedema as a social problem. (2) Methods: Materials on lipoedema in the social context were selected from 2018–2021. The PRISMA-Scr checklist was used in the review. (3) Results: Research has shown that more than 3/4 of patients with lipoedema are also overweight or obese. Patients with lipoedema have many comorbidities, and their presence negatively affects the quality of life. The quality of life in patients with lipoedema is lower than in healthy patients. (4) Conclusions: The number of studies available on lipoedema is low. Obesity is common in patients with lipoedema. Mental disorders increase the level of experienced pain. Lipoedema significantly reduces quality of life. A healthy lifestyle in patients with lipoedema could be helpful for prevention of complications and disability.

5 citations

Journal ArticleDOI
TL;DR: O questionário de rastreamento do lipedema é um instrumento prático, de fácil e rápida aplicação, that pode ser utilizado em nossa população para a identificação de possíveis pacientes com lipedem, aumentando o nível of suspeição no momento da anamnese e exame físico.
Abstract: Background Lipedema is greatly underdiagnosed and there is a lack of low-cost tools to facilitate diagnostic. We created a lipedema screening questionnaire based on a questionnaire for assessing symptoms. Objectives The study objectives were to identify relevant clinical questions, develop a screening questionnaire, and construct a model for predicting lipedema. Method A simplified questionnaire was constructed and administered to a sample of patients with and without lipedema and then the probability of correct diagnosis was analyzed. Results All 109 patients who answered the questionnaire were female and all of them understood the questions. A predictive model using individual question scores achieved an excellent probability of correct diagnosis, at 91.2%, and a predictive model based on total score also achieved a good probability of correct diagnosis, at 86.15%. Conclusions The lipedema screening questionnaire is a practical instrument that is quick and easy to administer and can be used with our population for identification of possible lipedema patients, raising the level of suspicion when taking a patient's history and conducting a physical examination.

5 citations

Journal ArticleDOI
TL;DR: In this paper, the authors discuss self-care support for women with lipoedema, a long-term, progressive condition usually presenting as symmetrical enlargement of the legs and buttocks, and mainly affecting women.
Abstract: Lipoedema is a long-term, progressive condition, usually presenting as symmetrical enlargement of the legs and buttocks, and mainly affecting women. Distinct from obesity or lymphoedema, lipoedema is associated with an unusual distribution and proliferation of diet-resistant inflammatory fat tissue. This article provides background to lipoedema diagnosis and discusses self-care support for women with lipoedema.

4 citations

Journal ArticleDOI
TL;DR: Assessment of the effects of graduated compression stockings on left ventricular (LV) rotational mechanics measured by three‐dimensional speckle‐tracking echocardiography (3DSTE) in lipedema patients found significant changes in LV rotational Mechanics could be detected among 14 women withlipedema after the use of compression garment.
Abstract: Lipedema is a lymphedema-masquerading symmetrical, bilateral and disproportional obesity Its conservative maintenance treatment comprises the use of flat-knitted compression pantyhoses Lipedema is known to be associated with left ventricular morphological and functional alterations The present study aimed to assess the effects of graduated compression stockings on left ventricular (LV) rotational mechanics measured by three-dimensional speckle-tracking echocardiography (3DSTE) in lipedema patients The present study comprised twenty lipedema patients (mean age: 458 ± 110 years, all females) undergoing 3DSTE who were also compared to 51 age- and gender-matched healthy controls (mean age: 398 ± 141 years, all females) 3DSTE analysis was performed at rest, and subsequent to 1 hour application of compression class 2 made-to-measure flat-knitted pantyhose Six lipedema patients showed significant LV rotational abnormalities Of the remaining fourteen lipedema patients LV basal rotation rotation showed significant reduction, while LV apical rotation showed significant increase with unchanged LV twist after a 60-minute use of compression garment Significant changes in LV rotational mechanics could be detected among 14 women with lipedema after the use of compression garment however six probands have special LV rotational abnormalities at baseline and/or after compression

4 citations


Cites background from "Lipedema: an overview of its clinic..."

  • ...maintenance phase however the most effective treatment is still the liposuction.(1,10) Pantyhose is an ideal compression garment because it covers all affected regions and the flat-knitted material fits best to irregularly shaped legs....

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  • ...Lipedema is characterized by cuffing sign (fat deposition spares feet), non-pitting oedema, easy bruising and pain and often remains refractory to various dietary restrictions.(1) From the cardiological point of view lipedema is known to be associated with higher aortic stiffness(5) and a recent clinical study showed a high incidence of altered left ventricular (LV) standard twodimensional (2D) echocardiographic parameters (significantly larger dimensions, end-diastolic and end-systolic volumes, transmitral flow Received: 10 November 2019 Revised: 8 April 2020 Accepted: 10 May 2020...

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  • ...Pantyhose is an ideal compression garment because it covers all affected regions and the flat-knitted material fits best to irregularly shaped legs.(1,11) Based on the prior finding that patients with lipedema tend to have altered LV rotational properties we wondered if the use of medical compression stockings (MCSs) could somehow affect LV rotational mechanics in addition to controlling edema....

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Journal ArticleDOI
28 Nov 2017
TL;DR: Das Lipödem ist eine häufiger unter postpubertären Frauen auftretende, ätiologisch unklare chronisch verlaufende Erkrankung with negativen Auswirkungen auf Selbstwertgefühl, Mobilität and Lebensqualität.
Abstract: Das Lipodem ist eine haufiger unter postpubertaren Frauen auftretende, atiologisch unklare chronisch verlaufende Erkrankung mit negativen Auswirkungen auf Selbstwertgefuhl, Mobilitat und Lebensqualitat. Die symmetrische, disproportionale Verteilung des Fettgewebes in Kombination mit Hamatomneigung und Schmerzhaftigkeit erlaubt die Diagnosestellung. Unbehandelt fuhrt die Erkrankung zu Arthrosen, sekundarem Lymphodem, eingeschrankter Beweglichkeit und psychosozialer Stigmatisierung. Die Behandlung erfolgt konservativ mittels komplexer Entstauungstherapie und operativ durch mikrokannulare Liposuktion in Tumeszenzanasthesie.

4 citations

References
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01 Jan 1988
TL;DR: It is proposed that the chapters on external causes of injury and poisoning, and factors influencing health status and contact with health services, should form an integral part of ICD-10, for the first time in its history based on an alphanumeric coding scheme.
Abstract: The International Classification of Diseases has, under various names, been for many decades the essential tool for national and international comparability in public health. This statistical tool has been customarily revised every 10 years in order to keep up with the advances of medicine. At first intended primarily for the classification of causes of death, its scope has been progressively widening to include coding and tabulation of causes of morbidity as well as medical record indexing and retrieval. The ability to exchange comparable data from region to region and from country to country, to allow comparison from one population to another and to permit study of diseases over long periods, is one of the strengths of the International Statistical Classification of Diseases, Injuries, and Causes of Death (ICD). WHO has been responsible for the organization, coordination and execution of activities related to ICD since 1948 (Sixth Revision of the ICD) and is now proceeding with the Tenth Revision. For the first time in its history the ICD will be based on an alphanumeric coding scheme and will have to function as a core classification from which a series of modules can be derived, each reaching a different degree of specificity and adapted to a particular specialty or type of user. It is proposed that the chapters on external causes of injury and poisoning, and factors influencing health status and contact with health services, which were supplementary classifications in ICD-9, should form an integral part of ICD-10. The title of ICD has been amended to "International Statistical Classification of Diseases and Related Health Problems"', but the abbreviation "ICD" will be retained.(ABSTRACT TRUNCATED AT 250 WORDS)

2,084 citations

Journal Article
TL;DR: It is shown that whilst good evidence for the use of compression is available in some clinical indications, there is much still to be discovered.
Abstract: Aim The aim of this study was to review published literature concerning the use of compression treatments in the management of venous and lymphatic diseases and establish where reliable evidence exists to justify the use of medical compression and where further research is required to address areas of uncertainty. Methods The authors searched medical literature databases and reviewed their own collections of papers, monographs and books for papers providing information about the effects of compression and randomized clinical trials of compression devices. Papers were classified in accordance with the recommendations of the GRADE group to categorize their scientific reliability. Further classification was made according to the particular clinical problem that was addressed in the papers. The review included papers on compression stockings, bandages and intermittent pneumatic compression devices. Results The International Compression Club met once in Vienna and corresponded by email in order to reach an agreement of how the data should be interpreted. A wide range of compression levels was reported to be effective. Low levels of compression 10-30 mmHg applied by stockings are effective in the management of telangiectases after sclerotherapy, varicose veins in pregnancy, the prevention of edema and deep vein thrombosis (DVT). High levels of compression produced by bandaging and strong compression stockings (30-40 mmHg) are effective at healing leg ulcers and preventing progression of post-thrombotic syndrome as well as in the management of lymphedema. In some areas no reliable evidence was available to permit recommendations of level of compression or duration of treatment. These included: management of varicose veins to prevent progression, following surgical treatment or sclerotherapy for varicose veins, and the level of compression required to treat acute DVT. Conclusion This review shows that whilst good evidence for the use of compression is available in some clinical indications, there is much still to be discovered. Little is know about dosimetry in compression, for how long and at what level compression should be applied. The differing effects of elastic and short-stretch compression are also little understood.

231 citations

Journal ArticleDOI
TL;DR: The common differential diagnosis in Western patients with lower limb swelling is secondary lymphedema, venous disease, lipedema, and adverse reaction to ipsilateral limb surgery.
Abstract: Hypothesis The causes and management of lower limb lymphedema in the Western population are different from those in the developing world. Objective To look at the differential diagnosis, methods of investigation, and available treatments for lower limb lymphedema in the West. Data Source A PubMed search was conducted for the years 1980-2002 with the keyword "lymphedema." English language and human subject abstracts only were analyzed, and only those articles dealing with lower limb lymphedema were further reviewed. Other articles were extracted from cross-referencing. Results Four hundred twenty-five review articles pertaining to lymphedema were initially examined. This review summarizes the findings of relevant articles along with our own practice regarding the management of lymphedema. Conclusions The common differential diagnosis in Western patients with lower limb swelling is secondary lymphedema, venous disease, lipedema, and adverse reaction to ipsilateral limb surgery. Lymphedema can be confirmed by a lymphoscintigram, computed tomography, magnetic resonance imaging, or ultrasound. The lymphatic anatomy is demonstrated with lymphoscintigraphy, which is particularly indicated if surgical intervention is being considered. The treatment of choice for lymphedema is multidisciplinary. In the first instance, combined physical therapy should be commenced (complete decongestive therapy), with surgery reserved for a small number of cases.

219 citations

Journal ArticleDOI
TL;DR: It is proposed that lipedema is a genetic condition with either X‐linked dominant inheritance or more likely, autosomal dominant inheritance with sex limitation, and appears to be a condition almost exclusively affecting females, presumably estrogen‐requiring as it usually manifests at puberty.
Abstract: Lipedema is a condition characterized by swelling and enlargement of the lower limbs due to abnormal deposition of subcutaneous fat. Lipedema is an under-recognized condition, often misdiagnosed as lymphedema or dismissed as simple obesity. We present a series of pedigrees and propose that lipedema is a genetic condition with either X-linked dominant inheritance or more likely, autosomal dominant inheritance with sex limitation. Lipedema appears to be a condition almost exclusively affecting females, presumably estrogen-requiring as it usually manifests at puberty. Lipedema is an entity distinct from obesity, but may be wrongly diagnosed as primary obesity, due to clinical overlap. The phenotype suggests a condition distinct from obesity and associated with pain, tenderness, and easy bruising in affected areas.

169 citations


"Lipedema: an overview of its clinic..." refers background in this paper

  • ...These strong familial background suggests that lipedema is a genetic disorder (22)....

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  • ...have recently found a Pit-1 mutation in members of a family with lipedema (47) and screening of lipedema family members strongly suggests inheritance (22)....

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