Acquired generalized lipodystrophy type 2-lawrence syndrome: a rare case report


  • Dhanalakshmi K. Department of Pediatrics, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India
  • Mohinish S. Department of Pediatrics, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India
  • Dakshayani B. Department of Pediatrics, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India
  • Mallesh K. Department of Pediatrics, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India



Acquired generalized lipodystrophy, Autoimmune hepatitis, Diabetes, Hyperglycemia, Lawrence syndrome, Leptins, Partial dystrophy


Lawrence syndrome (Acquired Generalized Lipodystrophy) is a rare disorder, characterized by various dermatological and systemic manifestations such as lipodystrophy, hypertriglyceridemia, hepatomegaly, acanthosis nigricans and acromegaloid features. Because of its rare occurrence we are reporting a case with similar manifestations in a 10 years old child.


Garg A. Acquired and Inherited Lipodystrophies. N Engl J Med. 2004;350:1220-34.

Misra A, Garg A. Clinical features and metabolic derangements in acquired generalized lipodystrophy: case reports and review of the literature. Med. 2003 Mar 1;82(2):129-46.

Tan SH, Sen P, Tang M. Lipodystrophies. In: Bolognia JL, Jorizzo JL, Schaffer JV, eds. Dermatology. 3rd ed. Elsevier; 2012;101(2):1663-1665.

Hegele RA, Joy TR, Al-Attar SA, Rutt BK. Lipodystrophies: Windows on adipose biology and metabolism. J Lipid Res. 2007;48:2531-46.

Garg A. Lipodystrophy. In: Lowell A, Stiphen I, Barbara A, Paller AS, Wolff K eds. Fitzpatrick’s Dermatology in General medicine.8th ed. New York: Macgraw Hill; 2013;71(1):755-763.

Agarwal AK, Arioglu E, de Almeida S, Akkoc N, Taylor SI, Bowcock AM, Barnes RI, Garg A. AGPAT2 is mutated in congenital generalized lipodystrophy linked to chromosome 9q34.Nat Genet 31: 21–3, 2002.

Agarwal AK, Garg A. A novel heterozygous mutation in peroxisome proliferator-activated receptor-gamma gene in a patient with familial partial lipodystrophy. J Clin Endocrinol Metab.2002;87:408–11.

American Academy of Paediatrics. National Cholesterol Education Program: Report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents. Pediatrics 89: 525–84, 1992.

Andreelli F, Hanaire-Broutin H, Laville M, Tauber JP, Riou JP, Thivolet C. Normal reproductive function in leptin-deficient patients with lipoatropic diabetes. J Clin Endocrinol Metab.2000; 85: 715–9.

Arioglu E, Duncan-Morin J, Sebring N, Rother KI, Gottlieb N, Lieberman J, Herion D, Kleiner DE, Reynolds J, Premkumar A, Sumner AE, Hoofnagle J, Reitman ML, Taylor SI. Efficacy and safety of troglitazone in the treatment of lipodystrophy syndromes. Ann Intern Med.2000;133:263–74.

Billings JK, Milgraum SS, Gupta AK, Headington JT, Rasmussen JE. Lipoatrophic panniculitis: A possible autoimmune inflammatory disease of fat. Report of three cases. Arch Dermatol 123: 1662–6, 1987.

Bjornstad PG, Semb BK, Trygstad O, Seip M. Echocardiographic assessment of cardiac function and morphology in patients with generalised lipodystrophy. Eur J Pediatr.1985;144:355–9.

Bohmer K, Hauner H, Phlippen R, Gries FA. Erfolgreiche Insulintherapie bei lipatrophischem Diabetes. Dtsch Med Wochenschr 116: 454–9, 1991.

Bolan C, Oral EA, Gorden P, Taylor S, Leitman SF. Intensive, longterm plasma exchange therapy for severe hypertriglyceridemia in acquired generalized lipoatrophy. J Clin Endocrinol Metab 87: 380–4, 2002.

Boucher BJ, Cohen RD, Frankel RJ, Mason AS, Broadley G. Partial and total lipodystrophy: Changes in circulating sugar, free fatty acids, insulin and growth hormone following the administration of glucose and of insulin. Clin Endocrinol 2: 111–26, 1973.

Bourke B, Powell D. Progression from partial to generalised lipodystrophy— a case report. Ir J Med Sci 161: 458–9, 1992.

Brechtel K, Jacob S, Machann J, Hauer B, Nielsen M, Meissner HP, Matthaei S, Haering HU, Claussen CD, and Schick F. Acquired generalized lipoatrophy (AGL): Highly selective MR lipid imaging and localized (1)H-MRS. J Magn Res Imaging 12:306–10, 2000.

Caldwell SH, Hespenheide EE, Redick JA, Iezzoni JC, Battle EH, Sheppard BL. A pilot study of a thiazolidinedione, troglitazone, in nonalcoholic steatohepatitis. Am J Gastroenterol 96: 519–25, 2001.

Catalano PM, Capeless EL, Simmons GM, Robbins DC, Horton ES. Successful pregnancy outcome in association with lipoatrophic diabetes mellitus. Obstet Gynecol 76: 978–9, 1990.

Chen D, Misra A, Garg A. Lipodystrophy in HIV-infected patients. J Clin Endocrinol Metab 87: 4845–56, 2002.

Coelho PC, Jordao A, Andre O, de Queiroz MV, Eurico-Lisboa P. Rheumatological manifestations of lipoatrophic diabetes. Clin Rheumatol 14: 229–30, 1995.

Commens C, O’Neill P, Walker G. Dermatomyositis associated with multifocal lipoatrophy. J Am Acad Dermatol 22: 966–9, 1990.






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