Lipedema is a disorder where there is an enlargement of both feet due to fatty deposits under the skin. It usually worsens over time, the pain may be present, and people bruise easily. In severe cases, the upper trunk and upper body may be involved.
The cause is unknown but is believed to involve genetics and hormonal factors. Often walking in the family. Risk factors include being overweight or obese. Other conditions that may be present include the same obesity, lipohypertrophy, chronic venous insufficiency, and lymphedema.
A number of treatments may be useful including physiotherapy and exercise. While surgery can remove fat tissue it can also damage the lymphatic vessels. Treatment usually does not produce complete resolution. It is estimated to affect up to 11% of women. Onset usually occurs during puberty, pregnancy, or menopause.
Video Lipedema
Signs and symptoms
People tend to gain weight in lipedematous areas and lose them in non-lipedematous areas, although there are cases where weight loss has resulted in improved conditions. Patients with obesity lipedema who undergo bariatric surgery lose fat mainly from the waist up. While lipedema emerges by itself in various ways, the diagnosis is possible as early as pre-puberty when the inner thigh pad is present and at any age when fat is assembled and suspended on the knee.
Symptoms of lipedema include very large legs, such as columns, enormous legs to knees, disproportionate hips, abdomen or buttocks. As the lipedema progresses, the patient becomes heavier in the lower body. Additionally, extending the fat cells interferes with the lymphatic vessel pathway, and the patient may develop secondary lymphedema, a condition known as lipo-lymphedema. Many lipedema patients can not tolerate the compression clothing associated with conventional lymphoedema treatment because the underlying lipedematous fat is very painful, and the patients are at risk for uncontrolled side effects of lymphoedema, including recurrent blood infections and fibrosis. If not continuously examined through a healthy lifestyle, lipo-lymphedema may worsen, and the patient will become progressively less mobile.
When the disease process progresses, there is fibrosis in the fat tissue. Conditions become painful, restricted and painful movements that cause orthopedic problems, and limited mobility. Pathological examination of abnormal tissue reveals the development of fibrosis which complicates treatment and interferes with mobilization or abnormal tissue removal. The diagnosis of "lipedema" is misleading and causes confusion with other conditions mentioned. A better diagnosis might be FIBROSING LIPODYSTROPY. There are many documented cases where the condition is family, and is present in women who are not overweight and thrive despite strict diet management.
Maps Lipedema
Cause
The cause is unknown. There is a possibility of genetically inherited risk factors because it is more likely to occur in first and second level relatives of affected individuals. It seems to be related to the influence of estrogen and progesterone hormones because it occurs exclusively after puberty and mostly in women. There is a strong inflammatory component.
Lipedema is usually triggered at puberty, but may precipitate or worsen during or after pregnancy, in the peri-menopause, and after gynecological surgery, ie uterine surgery, ovaries, or fallopian tubes or surgery under general anesthesia. Lipedema can also be triggered by a very stressful situation such as death in the family or divorce as cortisol levels rise, causing inflammation of inflammation, almost always misdiagnosed as simple weight gain.
Diagnosis
Lipedema is often misdiagnosed. At this time, only Germany and the Netherlands have a standard way to diagnose lipedema. Other countries today do not have standard diagnostic protocols, and therefore diagnosis is usually made clinically through physical examination (palpation of adipose tissue).
Some doctors and trained therapists can sense the physical difference in adipose tissue, which is marked as a nodule with the feeling of "beans in a bag". When the tissue has excess fluid, the nodule is no longer easy to palpable. Testing of major components of the lymphatic system can be done via tools such as lymphocyte limiting, but the absence of a real lymphatic disorder does not indicate lipedema is absent, only the major lymphatics are not (yet) affected.
Differential diagnosis
Lymphedema
Lymphedema is usually asymmetrical and can be obtained (via surgery, trauma or infections damaging the lymphatic system) or congenital (hereditary changes in the lymphatic system). However, symmetrical enlargement of both lower extremities, from the waist to the ankle (ie gynoid fat) is characteristic of lipedema. As the swelling continues and spreads from lower extremities to other parts of the body, the swelling may be caused by slower lymphatic flow and changes in lymphatic vessel structures caused by pressure on lipedematous limbs. This is known as lipo-lymphedema. Lipo-lymphedema can also develop in combination with chronic venous insufficiency and other blood vessel disorders.
Lipedema can be diagnosed because of difficulties in distinguishing it from edema and other obesity. Tray 2013 publishes several tools including tables and flowcharts that can be used to diagnose lipedema and other edema.
Differentiation of Lipedema/Dercum Disease This condition can occur simultaneously. Dercum disease is characterized by painful lipomas around the body.
Prevention
There is no known way to prevent lipedema. Some treatments, both conservative and surgical, may help some people delay or prevent symptoms worsening sometimes. If lipedema is diagnosed early, which is currently very rare, it is possible to prevent the significant expansion of lipedematous lipid cells and to alert patients to their high risk factors so that they can take appropriate action.
Treatment
A number of treatments may be useful including physiotherapy and exercise. While surgery can remove fat tissue it can also damage the lymphatic vessels. Treatment usually does not produce complete resolution.
Physical therapy
The medical treatment is designed primarily to address the secondary lymphedema part of the lipedema patient condition. This treatment includes a manual lymphatic drainage program and is bandaged by a lymphedema therapist, followed by the use of a specially mounted clothes or compression device - usually stockings, and occasionally biker shorts and/or arm compression. Compression prevents lymphedema recurrence, and in some patients lipedema may reduce the pain of lipedematous fat. There is currently no uniform medical procedure known to cure lipedema. Nevertheless, it is successfully managed through various techniques that are applied consistently to improve foot health and prevent the condition from returning to levels that are more difficult to manage. Management involves reducing dietary sodium intake, often, gentle exercises to improve circulation in the legs, such as rebound exercises, and typical treatment for lymphedema treatment.
Surgery
The use of surgery to treat this condition is controversial. Options include liposuction and lipectomy.
The highest quality research involves tumescent or super tumescent anesthesia and vibrant, vibrant liposuction, a cannula used by sparing lymph techniques. Treatment of lipedema with tumescent liposuction requires multiple procedures. In the United States, Health Insurance generally does not pay liposuction for lipedema, making it expensive. Liposuction under general anesthesia, without tumescent anesthesia, can be damaging and not recommended for treatment.
Prognosis
There is no uniform prognosis in all patients. Some patients manage symptoms with conservative and/or surgical treatment. Some patients develop into lipo-lymphedema, a condition in which lipedema and lipo-lymphedema occur. Some patients develop Dercum disease (adiposis dolorosa).
Complications
Complications include depression, anxiety, and pain.
Epidemiology
Estimates of lipedema events vary widely, and range as high as 11% of the post-puberty female population, with an estimated 17 million women in the US, and 370 million women worldwide affected. "11% of adult women" are often quoted but that is not proven at this time. "11% of adult women" came from an unpublished small study conducted in Germany at the Foeldi Clinic in 2006. It has been reported that it occurs in various races including Caucasians, African Americans and Indians but may be underrepresented. in non-Indian Asian races.
History
Although first identified in the United States, at the Mayo Clinic in 1940, lipedema is almost unknown in the country - for doctors or patients who have the disease. Lipedema is often confused with obesity, and a large number of patients currently diagnosed as obese are believed to have lipedema, either as a substitute or otherwise obese.
The word lipedema has several spellings. Lipedema is an American spelling, while lipoedema is used in the UK, Australia and Europe. Lipodema is also used occasionally.
In recent years, awareness of lipedema has increased from internet sources. LASS (Lipoedema Australia Support Society Inc.) formed and created a secret Facebook support page in 2012, from this original group, the remaining international members to create groups in the UK, USA and Canada. Grassroots caused by patient changes continue to encourage lipedema. Conferences in the Netherlands, Germany, Britain, Australia and the United States have been organized, partly initiated by groups originally held only through social media.
In 2008, Fat Disorders Research Society, Inc. was formed to help awareness and lipedema research, and in 2009 achieved a 501 (c) (US) non-profit US status. They held conferences in 2010, 2011 and 2014.
In 2012, Lipese published a lipedema manual entitled Lipedema: Help, Hope, and Healing written by Maggie McCarey and Tatjana van der Krabben.
In November 2012, the UK Health Service, the first NHS listed lipedema as an abnormal buildup of fat cells in the legs, thighs and buttocks. The acceptance of this national lipedema is largely due to the Lymphoedema Support Network and the administrators and members of Lipoedema Ladies who are an essential part of the grassroots movement. The NHS notes the only seemingly effective treatment for lipedema is a procedure called liposuction tumescent that is now routinely performed in the Netherlands and Germany.
In June 2015, the Society of Nuisance Disorders The study was granted membership organization status to NORD, the National Organization for Rare Disorders, which represented lipedema and related conditions such as Dercum disease.
See also
- Lymphedema
- Steatopygia
- Adiposis dolorosa
- Lipodystrophy
References
External links
Source of the article : Wikipedia
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