Myomectomy
When administered prior to myomectomy in women with uterine fibroids, misoprostol reduces operative blood loss and requirement of blood transfusion. Abortion
Misoprostol is used either alone or in conjunction with another medication (mifepristone or methotrexate) for medical abortions as an alternative to surgical abortion. Medical abortion has the advantage of being less invasive, and more autonomous, self-directed, and discreet. It is preferred by some women because it feels more "natural," as the drugs induce a miscarriage. It is also more easily accessible in places where abortion is illegal. The World Health Organization provides clear guidelines on the use, benefits and risks of misoprostol for abortions.Misoprostol is most effective when it is used in combination with methotrexate or mifepristone (RU-486). Mifepristone inhibits the signals of pregnancy hormones, eventually causing the uterine lining to degrade, similar to a period, which cause the embryo to detach from the uterus walls. Misoprostol then dilates the cervix and induces muscle contractions which clear the uterus. Misoprostol alone is less effective (typically 88% up to eight-weeks gestation). It is not inherently unsafe if medically supervised, but 1% of women will have heavy bleeding requiring medical attention, some women may have ectopic pregnancy, and the 12% of pregnancies that continue after misoprostol failure are more likely to have birth defects and are usually followed up with a more effective method of abortion.Most large studies recommend a protocol for the use of misoprostol in combination with mifepristone. Together they are effective in around 95% for early pregnancies.
Panniculitis is an inflammatory nodules of the subcutaneous fat, and in this type of AGL, adipose destruction originates locally at the infection or inflammation site and develops into generalized lipodystrophy. Autoimmune-associated AGL
AGL with autoimmune origin is responsible for about 25% of all AGL reports. Those with autoimmune origin stems from other autoimmune diseases, most commonly with juvenile dermatomyositis and autoimmune hepatitis, but also occurs with rheumatoid arthritis, systemic lupus erythematosus, and Sjogren syndrome. Idiopathic AGL
Although idiopathic AGL accounts for about 50% of all AGL, it can vary in its origin and it is unclear how it develops.No known preventive measurement has been reported. Mechanism
The exact pathophysiologic mechanism is mostly unknown; however, each of three main origins, autoimmune, panniculitis, or idiopathic, may have different mechanisms of pathogenesis.Normally, adipose tissues contain adipocytes to store fat for energy during fasting period and release leptin to regulate homeostasis of energy and sensitize insulin. In AGL patients, adipose tissues are insufficient and leads to fat deposition in non-adipose tissues, such as muscle or liver, resulting in hypertriglyceridemia. Continuous elevation in triglyceride levels further contributes to metabolic problems including insulin resistance. As the level of leptin in the body is proportional to the amount of adipose tissue present, AGL patients also have a deficiency of leptin which contributes to excessive eating and worsens the metabolic syndrome.In a few patients with AGL, the presence of antibodies against adipocyte has been identified.