Corticosteroid-Induced Multifocal and Extensive Lipomatosis: A Case Report 3
mesenteric or retroperitoneal ones. Lipomatosis is usu-
ally asymptomatic nevertheless; many nonspecific
symptoms could reveal this pathology [4,8-10]. In our
patient persistent dyspnea was the principal symptom.
Diagnosis of “Corticosteroid-induced multifocal and
extensive lipomatosis” in our case was retained by Com-
puterized tomography. This imaging and magnetic reso-
nance imaging are the principals tools to identify the dif-
ferents localizations of lipomatosis [1,5].
Treatment of lipomatosis is essentially medical. It is
based on the reduction or discontinuation of corticoste-
roid therapy if possible and the prescription of a hypo-
caloric diet, with restriction for four weeks of fast-acting
carbohydrate [6,7]. This treatment helps to reduce the
hyperinsulinemia and promotes lipolysis in adipose tis-
sue [6,7]. A more rational approach and concerted effort
should be applied in situations of corticosteroids use to
minimize their adverse effects and to evict a lipomatosis
complication. Our patient had a good evolution after diet
and progressive reducing of glucocorticoids thanks to
DMARDS onset. Surgery is required for complicated or
rapidly evolving forms [1]. The risks of surgery are im-
portant in these patients; it should be discussed taking
into account the clinical symptoms, the location and ex-
tent [2].
4. Conclusions
The lipomatosis steroid-induced is probably an underesti-
mated entity because of the prevalence of asymptomatic
forms. This diagnosis should be discussed in the context
of long-term corticosteroid. The scanner and MRI are the
key diagnostic tests, esp ecially in the early stages. Medi-
cal treatment is the first line treatment. Surgery is reser-
ved for complicated shapes.
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