title: Familial partial lipodystrophy, Dunnigan variety - challenges for patient care during pregnancy: a case report.
abstract: BACKGROUND
  Familial partial lipodystrophy, Dunnigan variety, is a recognised autosomal dominant disorder which is caused by heterozygous missense mutations in the lamin A/C gene. Dunnigan lipodystrophy is characterised by a variable loss of fat from the extremities and trunk, as well as an excess of subcutaneous fat in the chin and supraclavicular area. The associated metabolic abnormalities include: insulin resistance, diabetes, dyslipidaemia and low leptin levels.
  
  
  METHODS
  The authors studied the case of a 24-year-old caucasian pregnant woman, with a past medical history of acute pancreatitis, combined dyslipidaemia and diabetes mellitus. At 7 weeks of pregnancy she was referred to the outpatient endocrinology and obstetrics clinic for diabetes care. A physical examination revealed that she presented a loss of fat from the extremities and trunk and also had an excess of subcutaneous fat in the chin. Triglyceride levels were persistently high, and glycaemic control was only achieved through the administration of high doses of insulin (1.8 U/Kg/day). Dunnigan lipodystrophy was suspected and thus a genetic study was requested, which revealed the presence of c.1444C > T (p.Arg482Trp) heterozygote mutation in the lamin A/C gene.
  
  
  CONCLUSIONS
  This case is used to illustrate the importance of being able to recognise the clinical signs of this rare lipodystrophic syndrome, which may cause potentially severe consequences, and also the difficulties in treating it during pregnancy.
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism of the Centro Hospitalar de São João, Porto, Portugal. sandra.belo@gmail.com.|Faculty of Medicine of the University of Porto, Porto, Portugal. sandra.belo@gmail.com.|Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal. sandra.belo@gmail.com.
authors.forename: Sandra Patrícia Mota
authors.initials: SP
authors.lastname: Belo
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism of the Centro Hospitalar de São João, Porto, Portugal. acfmagalhaes@gmail.com.|Faculty of Medicine of the University of Porto, Porto, Portugal. acfmagalhaes@gmail.com.
authors.forename: Ângela Celeste
authors.initials: ÂC
authors.lastname: Magalhães
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism of the Centro Hospitalar de São João, Porto, Portugal. paula_freitas@sapo.pt.|Faculty of Medicine of the University of Porto, Porto, Portugal. paula_freitas@sapo.pt.|Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal. paula_freitas@sapo.pt.
authors.forename: Paula
authors.initials: P
authors.lastname: Freitas
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism of the Centro Hospitalar de São João, Porto, Portugal. davideccarvalho@gmail.com.|Faculty of Medicine of the University of Porto, Porto, Portugal. davideccarvalho@gmail.com.|Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal. davideccarvalho@gmail.com.
authors.forename: Davide Maurício
authors.initials: DM
authors.lastname: Carvalho
mesh_terms: D000273:Adipose Tissue / Q000473:pathology; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D052496:Lipodystrophy, Familial Partial / Q000473:pathology*; D008297:Male; D005791:Patient Care; D010375:Pedigree; D011247:Pregnancy; D055815:Young Adult