Obesity-induced Lymphedema Nonreversible following Massive Weight Loss
Identifieur interne : 000204 ( Pmc/Curation ); précédent : 000203; suivant : 000205Obesity-induced Lymphedema Nonreversible following Massive Weight Loss
Auteurs : Arin K. Greene ; Frederick D. Grant ; Reid A. MaclellanSource :
- Plastic and Reconstructive Surgery Global Open [ 2169-7574 ] ; 2015.
Abstract
Lymphedema is the progressive enlargement of tissue due to inadequate lymphatic function. Obesity-induced lymphedema of the lower extremities can occur once a patient’s body mass index (BMI) exceeds 50. We report our first patient with obesity-induced lower extremity lymphedema who was followed prospectively before and after weight loss. A 46-year-old woman with a BMI of 80 presented to our Lymphedema Program complaining of bilateral lower extremity swelling. Lymphoscintigraphy showed impaired lymphatic drainage of both lower extremities consistent with lymphedema. She was referred to a bariatric surgical weight-loss center and underwent a sleeve gastrectomy. After reaching her new steady-state BMI of 36 eighteen months following her procedure, lymphoscintigraphy showed no improvement in lower extremity lymphatic function. Patients at risk for obesity-induced lymphedema should be counseled that they should seek weight-loss interventions before their BMI reaches 50, a threshold at which point lower extremity lymphedema may occur. Unlike other comorbidities that reverse following massive weight loss, obesity-induced lymphedema may not resolve.
Url:
DOI: 10.1097/GOX.0000000000000398
PubMed: 26180727
PubMed Central: 4494496
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<p>Lymphedema is the progressive enlargement of tissue due to inadequate lymphatic function. Obesity-induced lymphedema of the lower extremities can occur once a patient’s body mass index (BMI) exceeds 50. We report our first patient with obesity-induced lower extremity lymphedema who was followed prospectively before and after weight loss. A 46-year-old woman with a BMI of 80 presented to our Lymphedema Program complaining of bilateral lower extremity swelling. Lymphoscintigraphy showed impaired lymphatic drainage of both lower extremities consistent with lymphedema. She was referred to a bariatric surgical weight-loss center and underwent a sleeve gastrectomy. After reaching her new steady-state BMI of 36 eighteen months following her procedure, lymphoscintigraphy showed no improvement in lower extremity lymphatic function. Patients at risk for obesity-induced lymphedema should be counseled that they should seek weight-loss interventions before their BMI reaches 50, a threshold at which point lower extremity lymphedema may occur. Unlike other comorbidities that reverse following massive weight loss, obesity-induced lymphedema may not resolve.</p>
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<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Greene</surname>
<given-names>Arin K.</given-names>
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<aff id="aff1">From the<label>*</label>
Department of Plastic and Oral Surgery, Lymphedema Program, Boston Children’s Hospital, Harvard Medical School, Boston, Mass.; and<label>†</label>
Division of Nuclear Medicine, Department of Radiology, Lymphedema Program, Boston Children’s Hospital, Harvard Medical School, Boston, Mass.</aff>
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<author-notes><corresp id="c1">Arin K. Greene, MD, MMSc, Department of Plastic and Oral Surgery, Boston Children’s Hospital, 300 Longwood Avenue, Boston, MA 02115, E-mail: <email xlink:href="arin.greene@childrens.harvard.edu">arin.greene@childrens.harvard.edu</email>
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<volume>3</volume>
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<month>4</month>
<year>2015</year>
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<date date-type="accepted"><day>24</day>
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<permissions><copyright-statement>Copyright © 2015 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. All rights reserved.</copyright-statement>
<copyright-year>2015</copyright-year>
<license><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.</license-p>
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<abstract><title>Summary:</title>
<p>Lymphedema is the progressive enlargement of tissue due to inadequate lymphatic function. Obesity-induced lymphedema of the lower extremities can occur once a patient’s body mass index (BMI) exceeds 50. We report our first patient with obesity-induced lower extremity lymphedema who was followed prospectively before and after weight loss. A 46-year-old woman with a BMI of 80 presented to our Lymphedema Program complaining of bilateral lower extremity swelling. Lymphoscintigraphy showed impaired lymphatic drainage of both lower extremities consistent with lymphedema. She was referred to a bariatric surgical weight-loss center and underwent a sleeve gastrectomy. After reaching her new steady-state BMI of 36 eighteen months following her procedure, lymphoscintigraphy showed no improvement in lower extremity lymphatic function. Patients at risk for obesity-induced lymphedema should be counseled that they should seek weight-loss interventions before their BMI reaches 50, a threshold at which point lower extremity lymphedema may occur. Unlike other comorbidities that reverse following massive weight loss, obesity-induced lymphedema may not resolve.</p>
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