Relapsing insulin-induced lipoatrophy, cured by prolonged low-dose oral prednisone: a case report
| Autor: | Ernst Chantelau, Jörg Praetor, Ludger W Poll, Ruth Praetor |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
medicine.medical_specialty
Insulin Analogue endocrine system diseases business.industry Endocrinology Diabetes and Metabolism Insulin medicine.medical_treatment Low dose Case Report medicine.disease Gastroenterology lcsh:Nutritional diseases. Deficiency diseases Endocrinology Prednisone Diabetes mellitus Internal medicine Internal Medicine Medicine Insulin lispro business Insulin injection Lipoatrophy lcsh:RC620-627 medicine.drug |
| Zdroj: | Diabetology & Metabolic Syndrome, Vol 3, Iss 1, p 33 (2011) Diabetology & Metabolic Syndrome |
| ISSN: | 1758-5996 |
| Popis: | Introduction Circumscript, progressing lipoatrophy at the insulin injection sites is an unexplained, however rare condition in diabetes mellitus. Case presentation We report a case of severe localised lipoatrophy developing during insulin pump-treatment (continuous subcutaneous insulin infusion) with the insulin analogue lispro (Humalog®) in a woman with type-1 diabetes mellitus. After 11 months of progressing lipoatrophy at two spots on the abdomen, low-dose prednisone (5-10 mg) p.o. was given at breakfast for 8 months, whereby the atrophic lesions centripetally re-filled with subcutaneous fat tissue (confirmed by MRI) despite ongoing use of insulin lispro. However, 4 weeks after cessation of prednisone, lipoatrophy relapsed, but resolved after another 2 months of low-dose prednisone. No further relapse was noted during 12 months of follow-up on insulin-pump therapy with Humalog®. Conclusion Consistent with an assumed inflammatory nature of the condition, low-dose oral prednisone appeared to have cured the lipoatrophic reaction in our patient. Our observation suggests a temporary intolerance of the subcutaneous fat tissue to insulin lispro (Humalog®), triggered by an unknown endogenous mechanism. |
| Databáze: | OpenAIRE |
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