Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2021; 9(27): 8199-8206
Published online Sep 26, 2021. doi: 10.12998/wjcc.v9.i27.8199
Madelung’s disease with alcoholic liver disease and acute kidney injury: A case report
Ling Wu, Ting Jiang, Yan Zhang, An-Qi Tang, Li-Hua Wu, Yu Liu, Ming-Quan Li, Liang-Bin Zhao
Ling Wu, Ting Jiang, An-Qi Tang, Li-Hua Wu, Yu Liu, Ming-Quan Li, Liang-Bin Zhao, Department of Nephrology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610072, Sichuan Province, China
Yan Zhang, Department of Ultrasound, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610072, Sichuan Province, China
Author contributions: Wu L, Jiang T, and Zhao LB contributed equally to this work and wrote the draft; Jiang T, Zhang Y, Tang AQ, and Liu Y collected the literature; Wu L and Wu LH conceptualized the article and revised the manuscript; Zhao LB and Li MQ were responsible for the revision of the manuscript for important intellectual content; all authors have read and approved the final manuscript.
Supported by the National Natural Science Foundation of China, No. 81973831; and the Sichuan Provincial Department of Finance, Sichuan Provincial Department of Labor and Social Security (2020) No. 201 Traditional Chinese Medicine Inheritance and Innovation Ten Thousands of Talents Project-Ye Chuanhui Studio.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Liang-Bin Zhao, MM, Attending Doctor, Department of Nephrology, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 Shierqiao Road, Chengdu 610072, Sichuan Province, China. zlb31928856@163.com
Received: April 23, 2021
Peer-review started: April 28, 2021
First decision: June 6, 2021
Revised: June 17, 2021
Accepted: August 31, 2021
Article in press: August 31, 2021
Published online: September 26, 2021
Abstract
BACKGROUND

Madelung’s disease (MD) is a rare disorder of lipid metabolism, characterized by the growth of unencapsulated masses of adipose tissue symmetrically deposited around the neck, shoulders, or other sites around the body. Its pathological mechanism is not yet known. One of the most common comorbidities in MD patients is liver disease, especially chronic alcoholic liver disease (CALD); however, no reports exist of acute kidney injury (AKI) with MD.

CASE SUMMARY

We report a 60-year-old man who presented with complaint of edema in the lower limbs that had persisted for 3 d. Physical examination showed subcutaneous masses around the neck, and history-taking revealed the masses to have been present for 2 years and long-term heavy drinking. Considering the clinical symptoms, along with various laboratory test results and imaging characteristics, a diagnosis was made of MD with acute exacerbation of CALD and AKI. The patient was treated with liver function protection and traditional Chinese medicine, without surgical intervention. He was advised to quit drinking. After 10 d, the edema had subsided, renal function indicators returned to normal, liver function significantly improved, and size of subcutaneous masses remained stable.

CONCLUSION

In MD, concomitant liver or kidney complications are possible and monitoring of liver and kidney functions can be beneficial.

Keywords: Madelung’s disease, Multiple symmetric lipomatosis, Drinking, Alcoholic liver disease, Acute kidney injury, Case report

Core Tip: Madelung’s disease (MD) is a rare disorder of lipid metabolism, characterized by symmetrically deposited unencapsulated masses of adipose tissue. Liver disease is one of the most common comorbidities of MD, but no reports exist of comorbid kidney disease. Here, we report a male patient, 60 years of age, diagnosed as MD with acute exacerbation of chronic alcoholic liver disease and acute kidney injury. This case reminds us that in the diagnosis and treatment of MD, in addition to the known liver comorbidities, we also need to consider renal function in order to detect any concomitant kidney disease.