Introduction to lipedema

By Thomas Wright MD FACPh FACP
Vein Magazine

Although lipedema was first described by Drs. Edgar Allen and Edgar Hines in 1940 at the Mayo Clinic, many physicians remain unaware of this medical condition or its symptoms (Hines, 1940). Lipedema is a chronic, progressive medical disease that causes a disproportionate amount of swollen fat deposition in the arms and/or legs. As lipedema worsens, the affected limbs feel heavy and can be painful. The condition is associated with easy bruising, especially in the affected limbs. As a result of the lack of awareness, many patients are not diagnosed or properly treated, or are not treated until they have progressed to more advanced stages of the disease.

Cause of Lipedema and Pathogenesis

Though the exact cause and pathogenesis of lipedema is unknown, it is thought to be a genetic disorder with autosomal dominant inheritance and sex limitation (A.H. Child, 2010). This is because it occurs much more frequently in first-and second-degree relatives of affected individuals—reported rates of family clustering are from 16% to 64% of cases (L.E. Wold, 1949) (C.A. Harwood, 1996)—and usually occurs in women, although it can occur in men. Hormonal influences play a role in the development and progression of the disease and, in the majority of patients, the disease usually starts imperceptibly after puberty, but may also develop at other periods of hormonal change, such as pregnancy or menopause.

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