Efavirenz
M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson in Kucers’ The Use of Antibiotics, 2017
Subsequent studies involving efavirenz combined with nucleoside/nucleotide drugs with a low potential for causing lipoatrophy have provided reassurance about the low risk of lipoatrophy with efavirenz. ACTG 5202 randomized patients to efavirenz or atazanavir–ritonavir, and abacavir plus lamivudine or tenofovir plus emtricitabine. In a substudy, ACTG A5224s, the risk of lipoatrophy (defined as 10% or greater in limb fat mass) at week 96 was low with efavirenz and no higher than with atazanavir–ritonavir in both the nucleoside/nucleotide backbone groups (McComsey et al., 2011b). In the STARTMRK study, similarly low rates of lipoatrophy at week 96 were described in those randomized to either efavirenz or raltegravir plus tenofovir plus emtricitabine (Lennox et al., 2010). An observational study of 44 patients treated with tenofovir plus emtricitabine and either efavirenz (21 patients) or lopinavir–ritonavir (23 patients) found that only 2 patients in each group had > 20% limb fat loss at 48 weeks; corresponding numbers for > 10% limb fat loss were 3 and 5 patients, respectively (Domingo et al., 2014).
Secondary Forms and Genetic Syndromes of Diabetes Mellitus
Jack L. Leahy, Nathaniel G. Clark, William T. Cefalu in Medical Management of Diabetes Mellitus, 2000
Normal fat distribution at birth, but subsequent generalized absence of fat. This syndrome is sporadic without familial aggregation. In half the cases, there is a preceding viral syndrome that may be important in the pathogenesis. The onset is usually in childhood or postpuberty. Clinical diabetes follows the lipoatrophy an average of 4 years later. Patients have hypeifaidrosis, hyperlipidemia, and hepatosplenomegaly, cirrhosis, and premature atherosclerosis.
Practice Paper 1: Answers
Anthony B. Starr, Hiruni Jayasena, David Capewell, Saran Shantikumar in Get ahead! Medicine, 2016
Lipoatrophy describes a localized loss of fat tissue, which may occur in people with diabetes at the site of repeated subcutaneous insulin injections. Lipohypertrophy is the accumulation of fat at the point of repeated subcutaneous injections. Both of these conditions can be avoided by regularly rotating injection sites.
Effect of lipodystrophy on self-esteem and adherence to antiretroviral therapy in people living with HIV
Published in AIDS Care, 2022
Larissa Rodrigues Siqueira, Gilmara Holanda da Cunha, Marli Teresinha Gimeniz Galvão, Marina Soares Monteiro Fontenele, Franscisco Vagnaldo Fechine, Melissa Soares Medeiros, Lavna Albuquerque Moreira
In this study, to be considered with lipodystrophy, the criteria should be met: diagnosis of lipodystrophy described in the patient's medical record, self-report of lipodystrophy by the patient, and clinical examination by an infectious disease doctor, considering (Alencastro et al., 2017; Finkelstein et al., 2015): (1) Lipoatrophy: reduction of fat in peripheral regions, such as arms, legs, face and buttocks, with muscular and venous prominence; (2) Lipohypertrophy: accumulation of fat in different parts of the body, mainly in the abdomen and back, gynecomastia in men and breast enlargement in women; (3) Mixed form: association of lipoatrophy and lipohypertrophy.
Arg1201Gln mutation of insulin receptor impairs tyrosine kinase activity and causes insulin resistance: a case report
Published in Gynecological Endocrinology, 2020
The Proband, a 13-year-old Chinese Zhuang girl, was admitted to the hospital for investigation of increased serum testosterone and insulin which were found on a routine health examination. She was an offspring of a nonconsanguineous marriage and had no signs of delayed social development and mental retardation. The results of partial physical examination were showed in Table 1. Her thelarche occurred at age 11 years, and pubarche, glandebalae occurred at age 12 years, but menarche had not occurred. The body hair is exuberant and bushy. AN was present in axillary area and interspersed acne was found on the back. Neither lipoatrophy of the limbs nor fat accumulation in the face and neck region was observed. Mammary gland was symmetrical and at Tanner stage 3, and excess hairs were seen on the areola. Thick pubic hairs presented inverted triangle. Mild hypertrophy of clitoris was noted. Other physical examination findings were normal.
Monogenic forms of lipodystrophic syndromes: diagnosis, detection, and practical management considerations from clinical cases
Published in Current Medical Research and Opinion, 2019
Camille Vatier, Marie-Christine Vantyghem, Caroline Storey, Isabelle Jéru, Sophie Christin-Maitre, Bruno Fève, Olivier Lascols, Jacques Beltrand, Jean-Claude Carel, Corinne Vigouroux, Elise Bismuth
Patient 2 also presented with BSCL, a rare disease with a reported prevalence of 0.01–4 per 100,000, depending on the world region29. The patient, who had the BSCL1 sub-type, was initially referred to hospital for diarrhea and failure to thrive, which are unusual symptoms in the diagnosis of congenital generalized lipodystrophy. Van Maldergem et al.16 described 17 patients with BSCL1, of whom 11 had their condition diagnosed before age 1 year. Only one patient had failure to thrive, but without diarrhea. Seven patients were referred for lipoatrophy (with a family history in two cases) and two for hepatomegaly.
Related Knowledge Centers
- Adverse Drug Reaction
- Antiviral Drug
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- Lipodystrophy
- Adipose Tissue
- Growth Hormone
- Glatiramer Acetate
- Multiple Sclerosis
- HIV-Associated Lipodystrophy