Corticosteroid-Induced Multifocal and Extensive Lipomatosis: A Case Report

Introduction: Corticosteroid-induced lipomatosis are uncommon situation. We report a case of an extensive lipomatosis in a rheumatoid arthritis patient, who received a long term steroid therapy. Case report: A 49-year-old rheumatoid arthritis woman, who received for two years a mean dose of 15 mg/ day of prednisone equivalent, was admitted to the hospital for a six months history of progressive abdominal distension and dyspnea. Physical exam revealed typical symptoms of Cushing’s syndrome and an important increase of abdominal volume. Lipomatosis diagnosis with mesenteric, mediastinal, retroperitoneal and epidural localizations, was rapidly confirmed by sonography and computed tomography (CT) exams. Management was based on corticosteroid reduction as well as use of hygiene and dietary measures. Therapeutic efficacy was noted on a clinical basis within one year. Discussion: lipomatosis occurs as a less known complication of long-term steroid therapy. Its localizations are numerous. Epidural and mediastinal lipomatosis are more frequent than mesenteric or retroperitoneal ones. Most frequently asymptomatic, lipomatosis could sometimes be revealed by false symptoms. Medical treatment including corticosteroid with drawal or reduction and calorie restriction, can lead to clinical improvement. Surgery is reseved in advanced forms with serious complications.