Pereira de Godoy Livia Maria, Guerreiro Godoy Maria de Fatima, Pereira de Godoy Jose Maria
Dermatology in Instituto Lauro de Souza Lima, Bauru, Brazil.
Researcher Group of the Clinica Godoy, Sao Jose do Rio Preto, SP, Brazil.
J Med Cases. 2022 Jun;13(6):249-252. doi: 10.14740/jmc3806. Epub 2022 Jun 2.
The aim of the present case study was to report the 3-year follow-up of a male patient with lipedema and subclinical systemic lymphedema evaluated using multi-segment bioimpedance. The report describes the case of a 53-year-old male with a history of oncological surgery involving lymph node clearance in the right inguinal region followed by radiotherapy and chemotherapy. The physical examination revealed lipedema and lymphedema in the right lower limb. The patient was submitted to multi-segment bioimpedance, circumference measurements and volumetry, with the detection of clinical lymphedema of the limb. The patient underwent intensive treatment for lymphedema using the Godoy Method, which resulted in a substantial reduction in the edema. However, at the 1-year follow-up, the patient had progressed to subclinical systemic lymphedema, followed a year later by clinical systemic lymphedema evaluated using multi-segment bioimpedance. Lipedema is less frequent in men compared to women, but the increase in weight is an aggravating factor in both sexes. This condition initially affects the lower limbs, progressing to subclinical systemic lymphedema, followed by clinical systemic lymphedema determined using multi-segment bioimpedance, demonstrating that edema in patients with lipedema may be systemic.
本病例研究的目的是报告一名患有脂肪性水肿和亚临床系统性淋巴水肿的男性患者，采用多节段生物电阻抗评估的3年随访情况。该报告描述了一名53岁男性的病例，其有肿瘤手术史，包括右侧腹股沟区淋巴结清扫术，随后进行了放疗和化疗。体格检查发现右下肢存在脂肪性水肿和淋巴水肿。对该患者进行了多节段生物电阻抗、周长测量和容积测量，检测出肢体临床淋巴水肿。该患者采用戈多伊方法接受了淋巴水肿强化治疗，水肿明显减轻。然而，在1年随访时，患者进展为亚临床系统性淋巴水肿，1年后经多节段生物电阻抗评估进展为临床系统性淋巴水肿。与女性相比，男性脂肪性水肿的发生率较低，但体重增加在两性中都是一个加重因素。这种情况最初影响下肢，进展为亚临床系统性淋巴水肿，随后经多节段生物电阻抗确定进展为临床系统性淋巴水肿，表明脂肪性水肿患者的水肿可能是全身性的。
