After reading the interesting case report by Llamas-Velasco et al.,1 we would like to add a comment.

The authors described a case of acquired generalized lipodystrophy (AGL) with muscle involvement. The index patient with AGL had normal muscle strength and biopsy report. The evidence of muscle involvement were the presence of high creatine kinase levels and a myopathic pattern on electromyography.

Furthermore, the patient had hypothyroidism with dyslipidemia for which she was receiving levothyroxine and fenofibrate. The authors do not mention neither the dose for these 2 drugs nor the effectiveness of the levothyroxine supplementation (the results of serum thyroid stimulating hormone level). High serum creatine kinase levels and a myopathic pattern on electromyography have been reported in patients with hypothyroidism and also in such patients when they are receiving hypolipidemic therapy (fenofibrate) even in the absence of clinical evidence of muscular involvement.2,3