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Fat redistribution syndrome

Last revised by Rohit Sharma on 17 Jan 2022

Fat redistribution syndrome (or HIV lipodystrophy syndrome) is seen in a number of AIDS patients on ART. It is characterized by typical changes in body fat distribution.

Biochemically, these patients have increased triglycerides, total cholesterol, low-density lipoprotein-cholesterol, and extremely low high-density lipoprotein-cholesterol.

Features of fat redistribution syndrome are the same in different modalities and include:

  • hypertrophy in the neck fat pad (buffalo hump)
  • increased fat in the abdominal region (protease paunch)
  • gynecomastia
  • loss of fat in the midface and extremities.

If left untreated, these patients develop and die of complications of metabolic origin such as cardiovascular diseases or diabetes mellitus. Biochemical features manifest before the clinical pictures become apparent.

For hypertrophy of the fat around the neck consider:

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