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Drug-induced lipodystrophy
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Drug-induced lipodystrophy

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Contributors: Michael D. Tharp MD, Neil Shear MD
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Synopsis

Drug-induced lipodystrophy is a recognized sequelae of antiretroviral therapy for patients with human immunodeficiency virus (HIV) infection. It is characterized by the loss of subcutaneous fat on the extremities and face and accumulation of fat in the abdomen and posterior neck / upper back. A 2001 study of 494 HIV-infected patients found that 85 (17%) developed lipodystrophy after a mean 18 months of follow-up. Most commonly implicated are the protease inhibitors, but nucleoside reverse transcriptase inhibitors have also been associated with lipodystrophy. Pancreatitis may also be seen in patients with lipodystrophy.

Codes

ICD10CM:
T50.995A – Adverse effect of other drugs, medicaments and biological substances, initial encounter

SNOMEDCT:
431347008 – Lipodystrophy associated with Human immunodeficiency virus infection

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Beradinelli-Seip and Seip-Lawrence are congenital and acquired forms, respectively, of total lipodystrophy, and both are associated with diabetes mellitus and hyperlipidemia. The abdomen may be protuberant in these disorders due to enlargement of the liver and spleen, but unlike HIV-associated lipodystrophy, areas of fat accumulation are not seen.

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Updated: 01/15/2018
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Drug-induced lipodystrophy
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Drug-induced lipodystrophy : Buffalo hump, Buttocks, Cheeks, Arms
Clinical image of Drug-induced lipodystrophy
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