title: Multiple benign symmetric lipomatosis--a differential diagnosis of obesity: is there a rationale for fibrate treatment?
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.
authors.affiliation: Centre of Extracorporeal Treatment and Lipid Disorders, Medical Policlinic, Bonn, Germany. heike.zeitler@ukb.uni-bonn.de
authors.forename: Zeitler
authors.initials: Z
authors.lastname: Heike
authors.forename: Ulrich-Merzenich
authors.initials: UM
authors.lastname: Gudrun
authors.forename: Richter Dirk
authors.initials: RD
authors.lastname: Frank
authors.forename: Hans
authors.initials: H
authors.lastname: Vetter
authors.forename: Peter
authors.initials: P
authors.lastname: Walger
mesh_terms: D002995:Clofibric Acid / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D006801:Humans; D008069:Lipomatosis, Multiple Symmetrical / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis* / Q000188:drug therapy; D012074:Remission Induction
chemical_list: D002995:Clofibric Acid