Late-onset acquired generalized lipodystrophy with muscle involvement

Acquired generalized lipodystrophy (ALG) is a rare disorder characterized by the loss of adipose tissue and often found in association with metabolic disorders. Its onset is extremely rare in patients over 65 years, with only 1 case reported to date. Furthermore, there have been no reports of associated muscle involvement in ALG. We present the case of a 78-year-old woman who experienced almost complete loss of subcutaneous adipose tissue over 6 years. During this period, she was also successively diagnosed with hypertension, hypertriglyceridemia, hypothyroidism, hepatic steatosis, and diabetes mellitus. Possible causes of cachexia, such as infections, neoplasms, and gastrointestinal disorders, were ruled out. The patient's creatinine kinase levels were repeatedly elevated and electromyography showed a myopathic pattern, although the biopsy and strength tests were normal.