An autosomal recessive syndrome of joint contractures, muscular atrophy, microcytic anemia, and panniculitis-associated lipodystrophy.
BACKGROUND
Genetic lipodystrophies are rare disorders characterized by partial or complete loss of adipose tissue and predisposition to insulin resistance and its complications such as diabetes mellitus, hypertriglyceridemia, hepatic steatosis, acanthosis nigricans, and polycystic ovarian syndrome.


OBJECTIVE
The objective of the study was to report a novel autosomal recessive lipodystrophy syndrome.


RESULTS
We report the detailed phenotype of two males and one female patient, 26-34 yr old, belonging to two pedigrees with an autosomal recessive syndrome presenting with childhood-onset lipodystrophy, muscle atrophy, severe joint contractures, erythematous skin lesions, and microcytic anemia. Other variable clinical features include hypergammaglobulinemia, hepatosplenomegaly, generalized seizures, and basal ganglia calcification. None of the patients had diabetes mellitus or acanthosis nigricans. Two had mild hypertriglyceridemia and all had low levels of high-density lipoprotein cholesterol. Skin biopsy of an erythematous nodular skin lesion from one of the patients revealed evidence of panniculitis. The lipodystrophy initially affected the upper body but later became generalized involving abdomen and lower extremities as well.


CONCLUSIONS
We conclude that these patients represent a novel autoinflammatory syndrome resulting in joint contractures, muscle atrophy, microcytic anemia, and panniculitis-induced lipodystrophy. The molecular genetic basis of this disorder remains to be elucidated.
Garg
Abhimanyu
A
Division of Nutrition and Metabolic Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas 75390, USA. abhimanyu.garg@utsouthwestern.edu
Hernandez
Maria Dolores
MD
Sousa
Ana Berta
AB
Subramanyam
Lalitha
L
Martínez de Villarreal
Laura
L
dos Santos
Heloísa G
HG
Barboza
Oralia
O
D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000150:complications* / Q000151:congenital / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D003286:Contracture / Q000150:complications* / Q000235:genetics; D005260:Female; D005808:Genes, Recessive; D006801:Humans; D007596:Joints / Q000002:abnormalities*; D008060:Lipodystrophy / Q000150:complications* / Q000151:congenital / Q000235:genetics; D008297:Male; D008875:Middle Aged; D009133:Muscular Atrophy / Q000150:complications* / Q000151:congenital / Q000235:genetics; D015434:Panniculitis / Q000150:complications* / Q000151:congenital / Q000235:genetics; D010375:Pedigree; D013577:Syndrome; D055815:Young Adult