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Low-Dose d-Amphetamine Induced Regression of Liver Fat Deposits in Dercum Disease
Sehem Ghazala1, Jawad Bilal1, Elle Ross1
1Department of Medicine, University of Arizona, Tucson.
Background:
Dercum disease is a rare disorder of painful subcutaneous adipose tissue masses typically presenting as a constellation of signs and symptoms affecting most organs, including slow lymphatic flow and fatty liver.
Method:
The University of Arizona Institutional Review Board considered this report exempt after patient consent. Multislice, multisequence magnetic resonance imaging (MRI) of the abdomen and pelvis was performed prior to and after d-amphetamine, with and without intravenous gadolinium.
Results:
Initial MRI demonstrated hepatic steatosis in Case 1; Case 2 had 2-subcentimeter lipid foci within the liver. Initiation of 10-20 mg d-amphetamine decreased liver lipid deposition from 16% to 4% in Case 1 and resolved fat deposits in Case 2 after ~1 year.
Conclusion:
There is a dire need for novel treatment options for nonalcoholic fatty liver disease to prevent progression to cirrhosis. Reduction of liver fat by d-amphetamine suggests a potential therapeutic role in nonalcoholic fatty liver disease.
Insights
Dercum disease, a rare disorder, involves painful fat masses and can affect the liver. D-amphetamine treatment significantly reduced liver fat in two patients, suggesting a potential therapy for fatty liver disease.
Area of Science:
- Hepatology
- Endocrinology
- Rare Diseases
Background:
- Dercum disease is a rare disorder characterized by painful subcutaneous adipose tissue.
- It can manifest with systemic symptoms, including impaired lymphatic flow and hepatic steatosis (fatty liver).
Observation:
- Two cases of Dercum disease with hepatic steatosis were evaluated.
- Magnetic resonance imaging (MRI) was used to assess liver fat deposition before and after d-amphetamine administration.
Findings:
- Initiation of d-amphetamine (10-20 mg daily) led to a significant reduction in liver lipid deposition.
- In Case 1, liver fat decreased from 16% to 4%; in Case 2, fat deposits resolved within approximately one year.
Implications:
- Nonalcoholic fatty liver disease (NAFLD) requires novel therapeutic strategies to prevent cirrhosis.
- D-amphetamine demonstrates a potential therapeutic role in managing hepatic steatosis associated with Dercum disease and potentially NAFLD.
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