Lipodystrophy is a recently recognized complication of Juvenile Dermatomyositis (JDM). The diagnosis has hitherto always been made only on physical appearance of the patient. We have quantified the patterns of fat distribution in cohort of JDM patients. This has never been done before in JDM.

Methods:

Twenty patients with JDM were enrolled along with an equal number of controls. Both groups underwent standard anthropometric measurements including assessment of skinfold thicknesses using Harpenden Skinfold Caliper. Glucose tolerance test and serum lipid estimations were carried out in the study group but not in controls.

Results:

JDM patients had lesser mean weight, height and mild upper arm circumference as compared to controls and these differences were statistically significant (p = 0.05). Forty percent (8/20) of study patients had lipodystrophy on physical appearance. When assessed by skinfold caliper there was loss of subcutaneous fat at the mid-axillary site in 65%, at subscapular in 60% and at suprailiac site in 55% respectively. Serum triglyceride levels were increased in 12 out of the 18 study patients in whom this test was carried out. Oral glucose tolerance test was normal in all 20 subjects.

Conclusion:

Sixty five percent of our patients with JDM were found to have loss of subcutaneous fat on quantification in contrast to 40% on physical appearance alone. Maximum fat loss occurred at the mid-axillary skinfold site. A significant number of JDM patients (66%) had hypertriglyceridemia. We hypothesize that lipodystrophy and hypertriglyceridemia could well be integral components of what may, in fact, be an “expanded JDM syndrome”.

RCIAPCON 2005 - Conference Abstracts.Pediatric Oncall [serial online] 2006 [cited 15 June 2006(Supplement 6)];3. Available from:
http://www.pediatriconcall.com/fordoctor/Conference_abstracts/
subcutaneous_juvenile_dermatomyositis.asp