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Laparoscopic sleeve gastrectomy for linear scleroderma.

Jason Kasza1, Fred Brody, Brian Wallace

  • 1Department of Surgery, The George Washington University Medical Center, Washington, DC 20037, USA.

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|May 15, 2010
PubMed
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Linear scleroderma, a rare autoimmune disorder, typically doesn't cause obesity. This case study details a patient who developed hemiobesity due to limited mobility from linear scleroderma, successfully treated with bariatric surgery.

Area of Science:

  • Autoimmune Connective-Tissue Disorders
  • Dermatology
  • Bariatric Surgery

Background:

  • Linear scleroderma is a rare, localized, nonsystemic autoimmune disorder affecting skin and subcutaneous tissues, characterized by unilateral fibrosis and atrophy, typically of lower extremities.
  • The condition's pathophysiology rarely leads to morbid obesity, making this case unique.

Observation:

  • A 45-year-old female with a 35-year history of unilateral linear scleroderma developed morbid obesity on the contralateral side.
  • Impaired exercise capacity due to linear scleroderma contributed to hemiobesity, leading to arthritis, lower back pain, and hypercholesterolemia.

Findings:

  • The patient underwent a laparoscopic sleeve gastrectomy for hemiobesity and associated comorbidities.
  • Post-surgery, she achieved a 75% excess weight loss (20 kg) within 12 months.

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  • Significant improvement in joint pain, back pain, and hypercholesterolemia was observed.

    • Implications:

    • This case highlights a unique application of sleeve gastrectomy for managing hemiobesity in patients with linear scleroderma.
    • It suggests bariatric surgery can be a viable option for improving quality of life and comorbidities in select cases of localized scleroderma-induced obesity.