“Buffalo Humps” Associated with Protease Inhibitors
Authors: John T. Schindler
Journal: Annals of Internal Medicine (1998)

Letters15 July 1998“Buffalo Humps” Associated with Protease InhibitorsJohn T. Schindler, MD, Katherine M. Spooner, MD, and Catherine F. Decker, MDJohn T. Schindler, MDNational Naval Medical Center; Bethesda, MD 20889-5600Search for more papers by this author, Katherine M. Spooner, MDNational Naval Medical Center; Bethesda, MD 20889-5600Search for more papers by this author, and Catherine F. Decker, MDNational Naval Medical Center; Bethesda, MD 20889-5600Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-2-199807150-00032 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Since the inception of protease inhibitors, unusual side effects resulting in body habitus changes have been seen with the use of indinavir (breast hypertrophy) [1] and ritonavir (abdominal girth) [2]. We recently cared for three patients who presented with the rapid onset of increasing cervicodorsal tissue (“buffalo humps”) while receiving protease inhibitors.Table 1 shows the characteristics of these patients. The average size of the cervicodorsal enlargement was 14 × 14 cm. None of the patients had signs of hypercortisolism or a history of steroid use. Findings on evaluation for Cushing disease were negative. Deep punch biopsies ...References1. Wong-Beringer A, Beringer P, Lovett MA. Hypertrophy of the breasts in a patient treated with indinavir. Clin Infect Dis. 1997; 25:937. Google Scholar2. Norvir (ritonavir) capsule product monograph. North Chicago: Abbott Laboratories; 1996. Google Scholar3. Ruane PJ. Atypical accumulation of fatty tissue [Abstract]. In: Program and Abstracts of the 37th Interscience Conference on Antimicrobial Agents and Chemotherapy, 28 September-1 October 1997, Toronto, Ontario, Canada: I-185. Google Scholar4. Murrell DF. A radical proposal for the pathogenesis of scleroderma. J Am Acad Dermatol. 1993; 28:78-85. Google Scholar5. Mann M, Piazza-Hepp T, Koller E, Gilbert C. Abnormal fat distribution in AIDS patients following protease inhibitor therapy: FDA summary [Abstract]. In: Program and Abstracts of the 5th Conference on Retrovirus and Opportunistic Infections, 1-5 February 1998, Chicago, Illinois: 412. Google Scholar Author, Article, and Disclosure InformationAuthors: John T. Schindler, MD; Katherine M. Spooner, MD; Catherine F. Decker, MDAffiliations: National Naval Medical Center; Bethesda, MD 20889-5600 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee Also“Buffalo Humps” Associated with Protease Inhibitors Raphael B. Stricker and Billi Goldberg “Buffalo Humps” Associated with Protease Inhibitors John T. Schindler , Katherine M. Spooner , and Catherine F. Decker Metrics Cited byThe HIV Outpatient Study—25 Years of HIV Patient Care and Epidemiologic ResearchPhysiotherapy of patients with lipodystrophy associated with HAARTLe syndrome lipodystrophique associé aux traitements antirétroviraux : aspects anatomo-cliniquesCorrelates of Risk of Adipose Tissue Alterations and Their Modifications over Time in HIV-1-Infected Women Treated with Antiretroviral TherapyIncidence of morphological and lipid abnormalities: gender and treatment differentials after initiation of first antiretroviral therapyThe Fat Redistribution Syndrome in Patients Infected with HIVClinical assessment of HIV-associated lipodystrophy in an ambulatory populationLipodystrophy-associated morphological, cholesterol and triglyceride abnormalities in a population-based HIV/AIDS treatment databaseRecombinant human growth hormone improves the fat redistribution syndrome (lipodystrophy) in patients with HIVEpidemiological and clinical aspects of the metabolic complications of HIV infection The fat redistribution syndrome“Buffalo Humps” Associated with Protease InhibitorsRaphael B. Stricker, MD and Billi Goldberg, MPAIndinavir/ritonavir/saquinavir 15 July 1998Volume 129, Issue 2Page: 164KeywordsAdipose tissueBiopsyConnective tissueFatsFibroblastsFood and Drug AdministrationProtease inhibitor therapyProtease inhibitorsResearch laboratories ePublished: 15 August 2000 Issue Published: 15 July 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...