relapsing insulin-induced lipoatrophy, cured by prolonged low-dose oral prednisone a case report复发insulin-induced脂肪萎缩,治愈长期低剂量口服强的松案例报告.pdfVIP

Chantelau et al. Diabetology Metabolic Syndrome 2011, 3:33 DIABETOLOGY /content/3/1/33 METABOLIC SYNDROME CASE REPORT Open Access Relapsing insulin-induced lipoatrophy, cured by prolonged low-dose oral prednisone: a case report 1* 2 2 3 Ernst A Chantelau , Ruth Praetor , Jörg Praetor and Ludger W Poll Abstract 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