Madelung's Disease as Unusual Cause of Asthenia

We report a case of benign symmetric lipomatosis, also known as Madelung's Disease among other names, whose first clinical manifestation was asthenia. It is a rare disease characterized by symmetric non-encapsulated lipomas distributed in the upper part of the body and limbs. It compromises/involves adipose tissue in deep structures of the neck, thorax, and abdomen. This case showed typical symptoms and signs of this syndrome such as altered thermalgesia and proprioceptive, vibratory, and autonomic sensibility. Typical hematological analytical variables have also been observed. Characteristically, lipomas were distributed around the neck, shoulders, upper arms and upper trunk. The case was relevant because the first symptom reported by the patient was asthenia, which was due to a very low hematocrit (7%). Another analytical abnormality was a low platelet count. A CT scan of the chest revealed symmetric lipomatosis in supraclavicular regions and mediastinal lipomatosis with fat pericardial infiltration. After two years of follow up he stopped going to the hospital.

Author(s):

Aranalde G* and Ringer A

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