<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2184-0628</journal-id>
<journal-title><![CDATA[Gazeta Médica]]></journal-title>
<abbrev-journal-title><![CDATA[Gaz Med]]></abbrev-journal-title>
<issn>2184-0628</issn>
<publisher>
<publisher-name><![CDATA[Círculo Médico]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2184-06282021000300211</article-id>
<article-id pub-id-type="doi">10.29315/gm.v1i1.456</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[Dispneia Como Manifestação Inicial de Doença Rara]]></article-title>
<article-title xml:lang="en"><![CDATA[Dyspnea as Manifestation of a Rare Disease]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gaudêncio]]></surname>
<given-names><![CDATA[Margarida]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Antunes]]></surname>
<given-names><![CDATA[Joana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Barreiro]]></surname>
<given-names><![CDATA[Ivo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bertão]]></surname>
<given-names><![CDATA[Maria Inês]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bessa]]></surname>
<given-names><![CDATA[Isabel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pereira]]></surname>
<given-names><![CDATA[Amélia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Distrital da Figueira da Foz Serviço de Medicina Interna ]]></institution>
<addr-line><![CDATA[Figueira da Foz ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Distrital da Figueira da Foz Serviço de Medicina Interna ]]></institution>
<addr-line><![CDATA[Figueira da Foz ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Distrital da Figueira da Foz Serviço de Medicina Interna ]]></institution>
<addr-line><![CDATA[Figueira da Foz ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital Distrital da Figueira da Foz Serviço de Medicina Interna ]]></institution>
<addr-line><![CDATA[Figueira da Foz ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>09</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>09</month>
<year>2021</year>
</pub-date>
<volume>8</volume>
<numero>3</numero>
<fpage>211</fpage>
<lpage>217</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2184-06282021000300211&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2184-06282021000300211&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2184-06282021000300211&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo A doença de Madelung é uma condição rara, caracterizada pelo depósito maciço de gordura. Esta doença é conhecida como lipomatose simétrica múltipla ou benigna. Encontram-se descritos dois tipos de doença. No tipo 1, a gordura acumula-se no pescoço, ombros, membros superiores e tronco superior. No tipo 2, os lipomas distribuem-se por todo o corpo, incluindo nos membros inferiores. Os doentes geralmente referem algum desconforto, no entanto, em casos avançados, os lipomas podem causar sintomas como dispneia ou disfagia. Os autores apresentam o caso clínico de um doente do género masculino de 70 anos, referenciado para o Serviço de Urgência por dispneia com alguns meses de evolução, com agravamento nos últimos 6 dias, associada a tosse. Ao exame objetivo, destacava-se a presença de lipomas a nível da região cervical e torácica, com distribuição simétrica e circulação venosa colateral. Em angio-tomografia computorizada (TC) cervical e torácica, evidenciou-se a presença de proliferação da gordura cervical simétrica sugestiva de doença de Madelung, com compressão da veia jugular e braquiocefálica direita, assim como, formação de veias colaterais e consolidação peribrônquica dos lobos inferiores e médio com broncograma aéreo. Admitido no Serviço de Medicina para antibioterapia e oxigénio suplementar. Apresentou uma evolução clínica e analítica favoráveis, tendo alta ao quinto dia de hospitalização, orientado para consulta de Cirurgia. O caso apresentado corresponde a uma doença de Madelung tipo 1, em que o envolvimento mais profundo levou ao desenvolvimento de dispneia, agravado por intercorrência infeciosa. O diagnóstico desta patologia é baseado sobretudo na história clínica, exame objetivo (com a presença de múltiplos lipomas simétricos) e estudo imagiológico. A etiologia desta patologia permanece desconhecida. Atualmente, a cirurgia é o único tratamento disponível, apesar da elevada taxa de recorrência.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Madelung&#8217;s disease is a rare condition characterized by a symmetrical and painless pattern of massive fatty deposits. The condition is also known as benign or multiple symmetric lipomatosis. Two types of this disease have been described. In type 1, fat accumulates around the neck, shoulders, upper arms and upper back. In type 2, lipomas are distributed over much of the body, including the hips and thighs. The patients complain of their appearance although, in advanced cases, the increase in lipomas could cause symptoms as dyspnea or dysphagia. The authors propose to present the clinical case of a 70-year-old male patient referred to the emergency department for dyspnea with a few months of evolution, with worsening in the last 6 days, associated with cough. At physical examination, had no changes, except the presence of lipomas at the cervical and upper thoracic and back levels, with symmetrical distribution and collateral venous circulation. Computed tomography (CT) angiography of neck and thorax have shown proliferation of cervical fat suggestive of Madelung&#8217;s disease, with compression of the jugular veins and right brachiocephalic vein, as well as formation of collateral veins and a peribronchial consolidation in the lower and middle lobes with air bronchogram. He was hospitalized for oxygen and empirically antibiotic therapy. He had a good clinical and analytical evolution and was discharged after 5 days of hospitalization, oriented to Surgery&#8217;s consultation. The case presented corresponds to a Madelung&#8217;s disease type 1, in which deep involvement conditioned the onset of dyspnea exacerbated by infectious intercurrence. The diagnosis of Madelung&#8217;s disease is primarily based on clinical history, physical examination and imaging studies. The clinical diagnosis is based on the recognition of the unique appearance of the patient. The etiology of this disease remains unknown. Currently, surgery is the only treatment available, despite the high recurrence rate.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Dispneia]]></kwd>
<kwd lng="pt"><![CDATA[Lipomatose Simétrica Múltipla]]></kwd>
<kwd lng="en"><![CDATA[Dyspnea]]></kwd>
<kwd lng="en"><![CDATA[Lipomatosis, Multiple Symmetrical]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Perera]]></surname>
<given-names><![CDATA[U]]></given-names>
</name>
<name>
<surname><![CDATA[Kennedy]]></surname>
<given-names><![CDATA[BA]]></given-names>
</name>
<name>
<surname><![CDATA[Hegele]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Multiple Symmetric Lipomatosis (Madelung Disease) in a Large Canadian Family with the Mitochondrial MTTK c.8344A&gt;G Variant]]></article-title>
<source><![CDATA[J Investig Med High Impact Case Rep]]></source>
<year>2018</year>
<volume>6</volume>
<page-range>2324709618802867</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Enzi]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Busetto]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Ceschin]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Coin]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Digito]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Pigozzo]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Multiple symmetric lipomatosis: clinical aspects and outcome in a long-term longitudinal study]]></article-title>
<source><![CDATA[Int J Obes Relat Metab Disord]]></source>
<year>2002</year>
<volume>26</volume>
<page-range>253-61</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nemi]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Maxit]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Lipomatosis Simétrica Múltiple (Enfermedad de Madelung)]]></article-title>
<source><![CDATA[Rev Hosp Privado Comunidad]]></source>
<year>2003</year>
<volume>6</volume>
<page-range>58</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mayor]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Arillo]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Tiberio]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[2006, Lipomatosis simétrica multiple: a propósito de un caso]]></article-title>
<source><![CDATA[Sist Sanit Navar]]></source>
<year>2006</year>
<volume>29</volume>
<page-range>433-7</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chen]]></surname>
<given-names><![CDATA[CY]]></given-names>
</name>
<name>
<surname><![CDATA[Fang]]></surname>
<given-names><![CDATA[QQ]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[XF]]></given-names>
</name>
<name>
<surname><![CDATA[Zhang]]></surname>
<given-names><![CDATA[MX]]></given-names>
</name>
<name>
<surname><![CDATA[Zhao]]></surname>
<given-names><![CDATA[WY]]></given-names>
</name>
<name>
<surname><![CDATA[Shi]]></surname>
<given-names><![CDATA[BH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Madelung's Disease: Lipectomy or Liposuction?]]></article-title>
<source><![CDATA[Biomed Res Int]]></source>
<year>2018</year>
<volume>2018</volume>
<page-range>3975974</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dökmetas]]></surname>
<given-names><![CDATA[HS]]></given-names>
</name>
<name>
<surname><![CDATA[Korkmaz]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Ozcelik]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Koyuncu]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Madelung's disease in a patient with diabetes mellitus]]></article-title>
<source><![CDATA[Skinmed]]></source>
<year>2007</year>
<volume>6</volume>
<page-range>247-9</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Busetto]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Sträter]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Enzi]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Coin]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Sergi]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Inelmen]]></surname>
<given-names><![CDATA[EM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Differential clinical expression of multiple symmetric lipomatosis in men and women]]></article-title>
<source><![CDATA[Int J Obes Relat Metab Disord]]></source>
<year>2003</year>
<volume>27</volume>
<page-range>1419-22</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rodrigues]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Madelung&#8217;s disease: a case report and literature review]]></article-title>
<source><![CDATA[Radiol Brasil]]></source>
<year>2012</year>
<volume>45</volume>
<page-range>129-31</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Harsch]]></surname>
<given-names><![CDATA[IA]]></given-names>
</name>
<name>
<surname><![CDATA[Schahin]]></surname>
<given-names><![CDATA[SP]]></given-names>
</name>
<name>
<surname><![CDATA[Fuchs]]></surname>
<given-names><![CDATA[FS]]></given-names>
</name>
<name>
<surname><![CDATA[Hahn]]></surname>
<given-names><![CDATA[EG]]></given-names>
</name>
<name>
<surname><![CDATA[Lohmann]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Konturek]]></surname>
<given-names><![CDATA[PC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Insulin resistance, hyperleptinemia, and obstructive sleep apnea in Launois-Bensaude syndrome]]></article-title>
<source><![CDATA[Obes Res]]></source>
<year>2002</year>
<volume>10</volume>
<page-range>625-32</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Roberts]]></surname>
<given-names><![CDATA[CC]]></given-names>
</name>
<name>
<surname><![CDATA[Liu]]></surname>
<given-names><![CDATA[PT]]></given-names>
</name>
<name>
<surname><![CDATA[Colby]]></surname>
<given-names><![CDATA[TV]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Encapsulated versus nonencapsulated superficial fatty masses: a proposed MR imaging classification]]></article-title>
<source><![CDATA[AJR Am J Roentgenol]]></source>
<year>2003</year>
<volume>180</volume>
<page-range>1419-22</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sánchez]]></surname>
<given-names><![CDATA[MD]]></given-names>
</name>
<name>
<surname><![CDATA[Rosendo]]></surname>
<given-names><![CDATA[MV]]></given-names>
</name>
<name>
<surname><![CDATA[Alvarez]]></surname>
<given-names><![CDATA[CP]]></given-names>
</name>
<name>
<surname><![CDATA[Caaveiro]]></surname>
<given-names><![CDATA[LP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Lipomatosis simétrica multiple: presentatación de dos formas clínicas diferentes y revisión de literatura]]></article-title>
<source><![CDATA[Med Intern]]></source>
<year>2006</year>
<volume>20</volume>
<page-range>243-6</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
