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Causes of Lipoatrophy

Lipoatrophy, or fat wasting, is one manifestation of a fat metabolism disorder known as lipodystrophy. People who take medications to treat HIV/AIDS often experience lipoatrophy after years of therapy, and injecting a number of other types of medications can cause people to lose significant amounts of fat known as adipose tissue from under their skins. Diseases and immune system disorders can also cause lipoatrophy.

  1. HIV/AIDS Medications

    • Long-term use of HIV/AIDS medications classified as protease inhibitors or nucleoside reverse transcriptase inhibitors is a leading cause of lipoatrophy. The HIV infection itself may also play a role in causing fat deposits in patients' faces, buttocks, arms and legs to waste away. The loss of adipose tissue in patients' faces can be quite pronounced, to the point that facial wasting sometimes gets classified and treated as its own separate health problem. Protease inhibitors include atazanavir (Reyataz from Bristol-Myers Squibb) and ritonavir (Norvir from Abbott). Nucleoside reverse transcriptase inhibitors include lamivudine (Epivir from GlaxoSmithKline) and stavudine (Zerit from Bristol-Myers Squibb). Many patients take both protease inhibitors and Nucleoside reverse transcriptase inhibitors.

    Corticosteroid Injections

    • Corticosteroids reduce swelling and other immune system responses in the body. When injected into adipose tissue rather than muscle tissue, corticosteroids can kill fat cells in a small area around the injection site and produce what a New Zealand dermatology website describes as a "dent." Injectable corticosteroids include cortisone and prednisone.

    Injections of Other Medications

    • Injecting insulin, penicillin, iron or a human growth hormone such as somatropin (e.g., Genotropin from Pfizer) can also cause localized lipoatrophy. More widespread destruction of adipose tissue can rarely follow the administration of vaccines against measles, chicken pox (i.e., varicella) and whooping cough (i.e., pertussis). This generalized form of lipoatrophy is known as Lawrence syndrome and may be accompanied by diabetes and high cholesterol.

    Infectious and Acquired Diseases

    • A number of infections and immune system disorders can cause lipoatrophy. After a disease or disorder such as lupus induces swelling in adipose tissue categorized as panniculitis, the affected individual can experience lipoatrophy in the part of the body where the swelling occurred. Similarly school-age children who contract viral infections or suffer from lupus, rheumatoid arthritis and impaired thyroid function can rarely develop a complication known as Barraquer-Simons syndrome that causes them to lose adipose tissue in their face and torso. after viral infections in near-pubescent children. A third type of disease-related lipoatrophy is Parry-Romberg syndrome, which comes on suddenly for unknown reasons and leads the person to lose fate, skin thickness and bone mass on one side of his or her face.

    Congenital Diseases

    • Five inherited disorders have lipoatrophy as defining symptoms. Children born with Berardinelli-Seip syndrome have little adipose tissue and are at risk for insulin resistance, gigantism, kidney and liver enlargement, pancreatitis, purple swatches on their skin (i.e. acanthosis nigricans) and excessive body hair. Kobberling syndrome, which has been identified only in female patients, causes bony hands and feet but thick rolls of fat around the stomach. Dunnigan syndrome causes more generalized lipoatrophy and often occurs in conjunction with muscular dystrophy, heart enlargement (i.e., cardiomyopathy), neuropathy and the rapid-aging disease called progeria.

      The extremely rare conditions of SHORT syndrome and mandibulo-acral dysplasia also have lipoatrophy as symptoms. The roughly two dozens individuals diagnosed with SHORT syndrome have also exhibited eye structure abnormalities, hyperflexibility, lower-abdominal (i.e., inguinal) hernias and short stature. Mandibulo-acral dysplasia resembles Dunnigan syndrome but also causes facial and skeletal deformities and slow growth during childhood.

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