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Drug-induced lipodystrophy
Other Resources UpToDate PubMed

Drug-induced lipodystrophy

Contributors: Khanyisile Dladla MBChB, FCDerm, Anisa Mosam MBChB, MMed, FCDerm, PhD, Ncoza C. Dlova MBChB, FCDerm, PhD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Lipodystrophy, or fat redistribution, is frequently seen in patients on long-term antiretroviral therapy (ART) for human immunodeficiency virus (HIV) infection.

The clinical manifestations include fat loss (lipoatrophy - on the face, extremities, and buttocks); fat gain (abdominal, dorsocervical, and breast lipohypertrophy); and mixed presentations (gain and loss).

The most commonly implicated ART drugs are nucleoside reverse transcriptase inhibitors, but protease inhibitors and, to a lesser extent, non-nucleoside reverse transcriptase inhibitors may less frequently be responsible.

Drug-induced lipodystrophy in patients with HIV on ART is associated with metabolic complications, an increased risk of cardiovascular disease, and pancreatitis.

Lipodystrophy can develop within months to 2 years after the initiation of ART, with changes in limb and waist circumference apparent in up to 35% of patients after 2 years of initiation of ART.

Oral corticosteroid therapy may also cause fat redistribution (both a cushingoid appearance and true, iatrogenic Cushing syndrome are possible). Lipohypertrophy or lipoatrophy can occur at insulin injection sites, and lipohypertrophy at pegvisomant injection sites has been reported.

Codes

ICD10CM:
E88.1 – Lipodystrophy, not elsewhere classified

SNOMEDCT:
713693008 – Lipodystrophy caused by antiretroviral drug

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Last Reviewed:12/03/2018
Last Updated:12/03/2018
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Drug-induced lipodystrophy
A medical illustration showing key findings of Drug-induced lipodystrophy : Buffalo hump, Buttocks, NRTI antiretroviral, Cheeks
Clinical image of Drug-induced lipodystrophy - imageId=512261. Click to open in gallery.  caption: 'Loss of subcutaneous fat affecting the arm of a patient with AIDS on a combination of medications.'
Loss of subcutaneous fat affecting the arm of a patient with AIDS on a combination of medications.
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