Lymphology in Research and Practice Official Organ of the German Society of Lymphology, German speaking Society of Lymphology, Society of Manual Lymphdrainage Dr. Vodder and other Lymphological Treatments and the Lymphologist Physicians Organization
Abstracts LymphForsch 1/2022
– full text in German –
The anthropometric parameter waist-to-height ratio in patients with lipohyperplasia dolorosa commonly referred to as lipedema
E. Brenner, M. E. Cornely
LymphForsch 26 (1) 2022, 6-14
Lipohyperplasia dolorosa (LiDo) – commonly referred to as lipedema – is a painful disproportionatebut symmetrical fat distribution disorder of the extremities. An accompanying proportional symmetrical adipose tissue proliferation in the sense of coincidental obesity can complicate the diagnosis and treatment of LiDo. Surprisingly, no valid anthropometric parameters are used to determine this obesity component. The oftenused parameter body mass index (BMI) lacks construct validity. An alternative is the waistto-height ratio (WHtR). This cross-sectional study investigated the WHtR in 62 patients at a German clinic for surgical lymphedema management. Only data (height, body weight, waist circumference, age, stage, BMI and WHtR) from the internal clinical register were routinely collected as part of patient care. Based on WHtR, 4 patients were underweight, 25 had a normal weight, 20 patients were overweight, and 13 patients were obese (Class I: n = 10, Class II: n = 3). Compared to the WHtR, BMI shows a general overestimate, which is to be expected. The WHtR does not show a correlation with age but rather with the morphological stage of the disease. BMI seems to systematically overestimate the cardiovascular and metabolic risk in patients with LiDo. Therefore, in our view, BMI should be replaced by WHtR in diagnosis and follow-up as well as in the planning of comparative studies.
Lipedema, lipohyperplasia dolorosa (LiDo), body mass index (BMI), waist-toheight ratio (WHtR)
Interventional therapy for vascular malformations
C. Loberg, F. Ziayee, D. Klee, B. Turowski, G. Antoch, J. Kirchner, L. Schimm.ller, P. Minko
LymphForsch 26 (1) 2022,15-22
Vascular malformations comprise a complex group of different entities and clinical presentations. Therapy calls for a high degree of specialization and experience and interdisciplinary collaborative efforts. A wide range of treatment options are available, including pharmaceutical, local, systemic and interventional strategies that can be combined as needed. The aim of therapy is to relieve symptoms and improve quality of
life. This article describes the classification of various types of vascular malformation and the interventional therapy options for treating the condition.
Vascular malformations, lymphatic malformation, arterio-venous malformation, venovenous malformation, ISSVA classification, sclerotherapy, embolization, electrosclerotherapy
Nutrition and lymphedema – Is there any such thing as a lymphedema diet?
LymphForsch 26 (1) 2022, 23-25
Chronic lymphedema is an inflammatory disorder characterized by high oxidative stress in the tissue. An antioxidant and anti-inflammatory diet has a positive impact on the disorder.
In this article we describe what food is suitable for patients with lymphedema and what food they should avoid.
lymphedema, inflammation, oxidative stress, antioxidant and anti-inflammatory diet
Persistent pain in patients with lipohyperplasia dolorosa despite bariatric surgery for concurrent obesity
M. E. Cornely
LymphForsch 26 (1) 2022, 26-28
Lipohyperplasia dolorosa (LiDo) cannot be managed with bariatric surgery. Significantlyreducing the fat in obese patients does not reduce the pain caused by lipohyperplasia dolorosa. This article aims to raise awareness about lipohyperplasia dolorosa in patients with concurrent obesity in order to achieve better treatment results for these women. Bariatric surgery, which is used to treat obesity, does not influence the
obligatory symptom of pain in patients with lipohyperplasia dolorosa.
Lipohyperplasia dolorosa, lipedema, concurrent obesity, bariatric surgery, persistent pain
Practical aspects of lymphedema compression garments for patients with obesity
LymphForsch 26 (1) 2022, 29-33
Fitting obese patients with compression garments involves many risks and challenges that need to be considered throughout therapy. Most important among them is motivationand mobilization of the patients, for whom compression therapy means improved quality of life. Furthermore, comorbidities such as CVI, osteoarthritis, PAOD, diabetes or cardiovascular diseases need to be considered. For example, combined compression offers a promising approach for managing lymphedema/mixed edema combined with obesity. However, measurement specialists require high expertise in material and product properties and familiarity with material-specific measuring methods is crucial. Due to large circumference and the large caliber leaps, only flat knitted compression products can be used. Interdisciplinary dialogue is a fundamental factor for successful compression therapy.
Compression garments, lymphedema, obesity, obesity-associated lymphedema