Diagnosis: Progressive Lipodystrophy; Chronic Urticaria and Arthralgia. Presented by Dr. Carl T. Nelson.
Eleven-year-old white female.
Four years ago, the child developed intermittent pain in the lower limbs and a diagnosis of Legg-Perthes disease was documented by roentgenograms of the hip. Two and one-half years ago, she developed urticarial lesions of the lower limbs, accompanied by swelling of the ankles and knees and high fever. Hives and arthralgia appeared intermittently with periods of remission lasting no more than one month. Shortly after the onset of the above symptoms, a definite change in facial appearance occurred, but this was soon masked by mooning which appeared after the institution of steroid therapy 18 months ago. The child has been treated with desensitization injections, corticosteroids, a host of antihistaminics and antibiotics with no permanent relief. She was admitted to the Babies Hospital 12 days ago, and therapy consisting of Chlor-Trimeton, cyproheptadine,