The potential liability to hypercatabolism in lipodystrophy remains to be fully elucidated. Here we report a 28‐year‐old Japanese woman with acquired generalized lipodystrophy, who presented with recurrence of panniculitis and anemia. After corticosteroid treatment was started, she showed rapid reductions in body weight and lean mass by 15% at maximum, accompanied by an elevated urea nitrogen/creatinine ratio, which recovered almost fully as the corticosteroid treatment was tapered and discontinued. She had multiple risk factors for hypercatabolism: lack of metabolic reserves, insulin resistance, and hyperglycemia due to lipodystrophy, lowered daily activity due to anemia, persistent inflammation, and wasting associated with panniculitis, and relatively insufficient energy and protein intake during hospitalization. More attention should be paid to the potential liability to hypercatabolism in patients with lipodystrophy, and to skeletal muscle loss as an adverse effect of corticosteroid treatment in patients at high risk, such as those with diabetes or decreased metabolic reserves.

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皮质类固醇引发的脂肪营养不良急性骨骼肌丧失：病例报告

脂肪营养不良中分解代谢过度的潜在原因仍有待充分阐明。在这里，我们报告了一名患有获得性全身性脂肪营养不良的 28 岁日本女性，她出现脂膜炎和贫血复发。开始皮质类固醇治疗后，她的体重和去脂体重迅速减少，最多减少 15%，并伴有尿素氮/肌酐比升高，随着皮质类固醇治疗逐渐减少和停止，该比例几乎完全恢复。她有多种分解代谢亢进的危险因素：代谢储备不足、胰岛素抵抗和脂肪营养不良导致的高血糖、贫血导致的日常活动减少、持续炎症和脂膜炎相关的消瘦，以及住院期间能量和蛋白质摄入相对不足。应更多关注脂肪营养不良患者可能出现的过度分解代谢，以及高危患者（例如糖尿病患者或代谢储备减少的患者）皮质类固醇治疗的不良反应导致骨骼肌丧失。