CORTICOSTEROID-INDUCED LIPOMATOSIS

Steroid-induced lipomatosis usually presents as a localized hypertroph y of the adipose tissue and seems more common than previously thought. Most patients develop this phenomenon after prolonged administration of moderate to high doses of oral corticosteroids. The localizations a re numerous and determine the clinical presentation. Often asymptomati c, they can also be revealed by worrying symptoms usually due to a com pressive syndrome. The most frequently reported localizations (spinal epidural, retro-orbital, mediastinal) are also the most clinically app arent. The cessation or reduction of steroid therapy, when medically p ossible, inconsistently results in the decrease or disappearance of th e lipomatosis deposits. Computerized tomography or magnetic resonance imaging are the most helpful diagnostic means. Interestingly, these li pomatoses have rarely been reported in patients with Cushing disease. Their pathophysiology remains poorly elucidated and may imply an inhib ition of the brown adipose tissue lipolysis.