Madelung Disease-a Challenge in Clinical Practice

Multiple Symmetric Lipomatosis (MSL) or Madelung’s disease is a rare disorder of the lipid metabolism characterized by symmetric growth of sometimes massive unencapsulated fatty deposits (lipomas) in anatomical regions ranging from typical sites such as neck, occipital area, upper arms, face, abdomen and back to the more unusual involvement of the scrotum and the tongue. In this article we present the diagnostic and therapeutic challenges in a patient developing an acute oligoarticular attack of gout generating important functional incapacity, alcoholic liver disease potentially evolving to liver cirrhosis, heart and kidney failure, bilateral parotid gland region swelling and Madelung disease. The recognition and screening for potential complications related to the Madelung disease is of great practical importance because treatment priorities should be stratified accordingly.