ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Clinical Diabetes
This article is part of the Research TopicCase Reports in Autoimmune and Autoinflammatory Disorders: Volume IIView all 39 articles
Case Report: Generalized lipodystrophy following immune-checkpoint inhibitor therapy
Provisionally accepted
- 1Westmead Hospital, Westmead, Australia
- 2Westmead Institute for Medical Research, Sydney, Australia
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Immune-related adverse events secondary to immune checkpoint inhibitors (ICI) are increasingly recognised. Lipodystrophy is a rare condition which results in the selective loss of adipose tissue. We describe a case of a 48-year-old woman who had been treated with pembrolizumab for lymph node-positive breast cancer. She was referred to the diabetes service for worsening hyperglycemia, hypertriglyceridemia, and rapid onset of weight loss which occurred a year into pembrolizumab therapy. Examination was consistent with a diagnosis of severe lipodystrophy with severe loss of facial and limb adipose tissue. Investigations including a low leptin level and loss of adiposity on whole body composition analysis were consistent with this diagnosis. A trial of pioglitazone was associated with an improvement in insulin resistance and hypertriglyceridemia, although no improvement in her facial lipodystrophy was observed.
Keywords: Lipodystrophy, Immunotherapy, Checkpoint inhibitor therapy, Adipose, diabetes
Received: 22 Sep 2025; Accepted: 24 Nov 2025.
Copyright: © 2025 Lee, Hui and Gunton. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jenny Gunton, jenny.gunton@sydney.edu.au
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