Lipedema in a male patient: familial evidence and clinical response to nutritional intervention – case report
Lipedema em paciente masculino: evidência familiar e resposta clínica à intervenção nutricional – relato de caso
Michelle Kaefer; Bruna Candia Piccoli; Sabrina Fontana de Andrade; Laura Eduarda de Oliveira; Ighor Seiji Okumura Tioda; Luisa Buhse Pasqualoto; Clóvis Paniz; José Antonio Mainardi de Carvalho
Abstract
Keywords
Resumo
O lipedema é um distúrbio crônico do tecido adiposo que afeta predominantemente mulheres, embora ocorram casos raros em homens. Relatamos o caso de um homem de 32 anos com acúmulo simétrico de gordura nos membros inferiores, dor, preservação dos pés, tendência a equimoses e histórico familiar positivo para lipedema. Sua prima de primeiro grau apresentava fenótipo clássico. A absorciometria por dupla emissão de raios X demonstrou maior acúmulo de gordura na região ginoide do que nas regiões androide e visceral, reforçando um padrão de adiposidade predominantemente gluteofemoral. O paciente foi submetido a intervenção nutricional personalizada por sete meses, baseada em dieta hipocalórica moderada, hiperproteica e de baixo índice glicêmico, associada à suplementação de vitamina D e à prática regular de atividade física. Essa intervenção resultou em redução das medidas antropométricas e diminuição dos escores de dor na Escala Visual Analógica. Os exames laboratoriais revelaram preservação do eixo hipotálamo-hipófise-gônadas, exceto por uma hiperprolactinemia idiopática leve, que se normalizou durante o acompanhamento. Este caso destaca a ocorrência de lipedema em homens e os potenciais benefícios de intervenções precoces baseadas em mudanças no estilo de vida.
Palavras-chave
References
1 Buck DW II, Herbst KL. Lipedema: a relatively common disease with extremely common misconceptions. Plast Reconstr Surg Glob Open. 2016;4(9):e1043.
2 Rasmussen JC, Aldrich MB, Fife CE, Herbst KL, Sevick-Muraca EM. Lymphatic function and anatomy in early stages of lipedema. Obesity (Silver Spring). 2022;30(7):1391-1400.
3 Chen SG, Hsu SD, Chen TM, Wang HJ. Painful fat syndrome in a male patient. Br J Plast Surg. 2004;57(3):282-6.
4 Bertlich M, Jakob M, Bertlich I, Schift R, Bertlich R. Lipedema in a male patient: report of a rare case – management and review of the literature. GMS Interdiscip Plast Reconstr Surg DGPW. 2021;10:Doc11. PMid:34660173.
5 Cadart O, Le Moal C, Michelet M, et al. Lipedema and Klinefelter syndrome in two morbidly obese patients. Androg Clin Res Ther. 2021;2(1):134-40.
6 Pereira de Godoy LM, de Fatima GGM, de Godoy JMP. Lipedema in male progressing to subclinical and clinical systemic lymphedema. J Med Cases. 2022;13(6):249-52.
7 Alim SC, Suryana K. Lipedema subsequent with lymphedema and obesity in a male patient: a rare case. Int J Res Med Sci. 2022;10(11):2643-6.
8 Amato AC, Amato JS, Benitti D, Santos KD. Lipedema in men: a retrospective case series of five patients from a Brazilian referral center. Cureus. 2025;17(7):e87332.
9 Kruppa P, Georgiou I, Ghods M, Biermann N, Prantl L, Klein-Weigel P. Lipedema: pathogenesis, diagnosis, and treatment options. Dtsch Arztebl Int. 2020;117(22-23):396-03. PMid:32762835.
10 Patton L, Ricolfi L, Bortolon M, et al. Observational study on a large Italian population with lipedema: biochemical and hormonal profile, anatomical and clinical evaluation, self-reported history. Int J Mol Sci. 2024;25(3): 1599.
11 Lundanes J, Sandnes F, Gjeilo KH, et al. Effect of a low-carbohydrate diet on pain and quality of life in female patients with lipedema: a randomized controlled trial. Obesity (Silver Spring). 2024;32(6):1071-82.
12 Vilar L, Abucham J, Albuquerque JL, et al. Controversial issues in the management of hyperprolactinemia and prolactinomas: an overview by the Neuroendocrinology Department of the Brazilian Society of Endocrinology and Metabolism. Arch Endocrinol Metab. 2018;62(2):236-63.
13 Amato ACM, Peclat APRM, Kikuchi R, et al. Brazilian Consensus Statement on Lipedema using the Delphi methodology. J Vasc Bras. 2025;24:e20230183.
14 Morgan S, Reid I, Bendon C, et al. A family-based study of inherited genetic risk in lipedema. Lymphat Res Biol. 2024;22(2):106-11.
15 De Rosa M, Zarrilli S, Di Sarno A, et al. Hyperprolactinemia in men: clinical and biochemical features and response to treatment. Endocrine. 2003;20(1-2):75-82.
16 Melmed S, Casanueva FF, Hoffman AR, et al. Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(2):273-88.
17 Casanueva FF, Molitch ME, Schlechte JA, et al. Guidelines of the Pituitary Society for the diagnosis and management of prolactinomas. Clin Endocrinol (Oxf). 2006;65(2):265-73.
18 Ben-Jonathan N, Hugo E. Prolactin in adipose tissue: regulation and functions. Adv Exp Med Biol. 2015;846:1-35.
19 Marano RJ, Ben-Jonathan N. Minireview: extrapituitary prolactin: an update on the distribution, regulation, and functions. Mol Endocrinol. 2014;28(5):622-33.
20 Barrett R, Narasimhulu CA, Parthasarathy S. Adrenergic hormones induce extrapituitary prolactin gene expression in leukocytes: potential implications in obesity. Sci Rep. 2018;8(1):1936.
21 Al-Ghadban S, Cromer W, Allen M, et al. Dilated blood and lymphatic microvessels, angiogenesis, increased macrophages, and adipocyte hypertrophy in lipedema thigh skin and fat tissue. J Obes. 2019;2019:8747461.
22 Grewal T, Kempa S, Buechler C. Lipedema: a disease triggered by M2 polarized macrophages? Biomedicines. 2025;13(3):561.
23 Buso G, Favre L, Vionnet N, et al. Body composition assessment by dual-energy X-ray absorptiometry: a useful tool for the diagnosis of lipedema. Obes Facts. 2022;15(6):762-73.
24 Brenner E, Forner-Cordero I, Faerber G, Rapprich S, Cornely M. Body mass index vs waist-to-height ratio in patients with lipohyperplasia dolorosa (vulgo lipedema). J Dtsch Dermatol Ges. 2023;21(10):1179-85.
Submitted date:
01/18/2026
Accepted date:
07/30/2026
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email