Dercum’s disease is a rare condition, the most common symptom of which are growths composed of fatty tissue called lipomas. The growths sit just under the skin and often cause moderate to severe pain. Generally, lipomas develop on the torso, upper arms, and upper legs. Some people experience other symptoms, particularly if the lipomas press on nearby nerves. Experts and medical texts may also refer to Dercum’s disease as Anders disease and adiposis dolorosa.
Four Cardinal Symptoms
Some doctors use four cardinal symptoms to diagnose Dercum’s disease. The first is the growth of painful lipomas in various locations. Physicians also consider obesity a cardinal symptom, particularly in individuals older than 45. The third symptom is a general feeling of weakness or fatigue, and the final symptom is actually a variable group of possible symptoms. Doctors look for any signs of emotional instability, epilepsy, confusion, dementia, or depressive disorder.
Other Possible Symptoms
Beyond the cardinal symptoms, people with Dercum’s disease may develop or experience a variety of additional symptoms. Many bruise easily, with even minor trauma being enough to leave a mark. The disease may also cause some people to have trouble sleeping. Others experience issues breathing, elevated heart rates, or throbbing joint pains. Dercum’s disease also affects an individual’s brain, sometimes causing difficulty with concentration or memory. Rarely, parts of the upper body, especially the hands, begin to swell.
Minimal Definition and Pain
Because there are so many possible symptoms of Dercum’s disease, researchers created a minimal definition of symptoms for diagnosis. In short, the patient should meet the criteria for obesity or be overweight. Additionally, they should experience chronic pain originating from their adipose tissue. The pain of Dercum’s disease can last for hours and may vary from mild to severe. Patients frequently report that the pain is widespread and that all of the fat in their body hurts.
Causes of Dercum’s Disease
Medical experts and researchers have not yet found the exact cause of Dercum’s disease. Current findings suggest the condition appears spontaneously and sporadically. Some researchers suggest Dercum’s disease may be an autoimmune disorder. Other findings show the disease disturbs endocrine function and metabolism, another potential cause. One study linked Dercum’s disease to high doses of corticosteroids, which doctors often prescribe to treat asthma, food allergies, ulcerative colitis, and Crohn’s disease.
Genetics
There is some evidence that Dercum’s disease is genetic and runs in families. Medical literature on this topic proposes an autosomal dominant trait, which means a child could inherit the disease with a copy of a single abnormal gene from either parent or as the result of a mutation. There is not currently enough research to verify these findings, though many ongoing studies focus on Dercum’s disease.
Affected Populations
Dercum’s disease affects females more often than males, though the exact occurrence rate remains unknown. Some reports indicate Dercum’s disease is up to 20 times more common in females. Most of the women Dercum’s disease affects are between the ages of 45 and 60. Of these, the condition is most prevalent in postmenopausal women who meet the criteria for an overweight classification. Though it is extremely rare, physicians have found Dercum’s disease in children. However, because of its rarity and the difficulty of diagnosis, researchers believe the disease is underdiagnosed.
Diagnosis
Health care professionals may struggle to diagnose Dercum’s disease because there are no laboratory markers for the disease. Doctors will often make judgment calls for diagnosis after closely observing a patient’s medical history and confirming the presence of multiple Dercum’s disease symptoms. If there is any uncertainty, technicians may perform tests and lab work to rule out other conditions. Hormonal studies can rule out conditions such as thyroid abnormalities or Cushing syndrome. Magnetic resonance imaging (MRI) scans can confirm that the growths are lipomas.
Possible Treatments
Because Dercum’s disease is rare, there is a lack of knowledge about successful treatment plans. Generally, treatment aims to reduce specific symptoms. Many doctors prescribe use painkillers to reduce the severity of painful episodes, though this option appears to have limited effectiveness. Steroid hormones may alleviate pain in some patients. Nonsteroidal anti-inflammatory drugs also show some promise in diminishing pain for people with Dercum’s disease. Weight loss does not affect the lipomas and has actually aggravated symptoms in some patients.
Surgery
Doctors have attempted various surgical treatments for Dercum’s disease. Surgical removal of fat through liposuction or lipectomy can reduce pain in the short term, though this symptom almost always returns. There is often little point in surgeons performing liposuction as it does not significantly improve the quality of life. Surgeons may attempt to alleviate mobility issues and joint pain by removing fatty tissue deposits around the joints, particularly in the upper body.
Alternative Treatments
Several clinical studies and research projects are attempting to identify effective treatments for Dercum’s disease. One such study discovered that a medication for treating hepatitis C also appears to ease the symptoms. Currently, the research is focusing on the long-term efficacy and safety of this medication. Some patients have attempted alternative medicine approaches such as acupuncture, hypnosis, and biofeedback. Cognitive behavioral therapy may help patients learn to handle their symptoms mentally and improve their quality of life.