Originally, Dercum  attributed the disease to an endocrine dysfunction, as he found atrophy of the thyroid gland. Similarly, Waldorp  proposed that the disease is caused by hypophyseal dysfunction. Furthermore, Winkelman and Eckel  reviewed 16 autopsies of patients affected with Dercum’s disease and noted varying abnormalities in different endocrine organs. In their study, the pituitary gland was abnormal in eight of eleven cases examined, the thyroid in twelve cases, the sex glands in nine, the adrenal glands in three and the pancreas in two cases.
However, endocrine involvement was doubted as early as in 1933  and further ruled out in 1952 . In addition, present-day methods have not revealed any endocrine abnormalities [6,7,8,9,10]. For example, Piementa et al.  have demonstrated that hormonal secretion was normal both basally and during a 24 h period in a patient with Dercum’s disease, and no normal hormonal deficiency could be detected after an integrated pituitary stimulus test. The study suggested that there are probably no alterations of the endocrine glands, as regards the pituitary gland, the adrenal glands, the thyroid and the ovaries, in patients with Dercum’s disease.
An endocrine dysfunction as the aetiology of Dercum’s disease has little support in the modern literature.
1. Dercum FX: Three cases of a hitherto unclassified affection resembling in its grosser aspects obesity, but associated with special nervous symptoms – adiposis dolorosa. Am J Med Sci 1892, 101:521–523. 2. Waldorp NW: An original clinical interpretation of Dercum’s disease (adiposis dolorosa). Endocrinology 1924, 8:51–60. 3. Winkelman N, Eckel JL: Adiposis dolorosa (Dercum’s disease): a clinicopathologcal study. JAMA 1925, 85:1935–1939. 4. Rosenberg B, Hurwitz A, Hermann H: Decum’s disease with unusual retroperitoneal and paravesical fatty infiltration. Surgery 1963, 54:451–455. 5. Steiger WA, Litvin H, Lasche EM, Durant TM: Adiposis dolorsa (Dercum’s disease). N Engl J Med 1952, 247:393–396. 6. Blomstrand R, Juhlin L, Nordenstam H, Ohlsson R, Werner B, Engstrom J: Adiposis dolorosa associated with defects of lipid metabolism. Acta Derm Venereol 1971, 51:243–250. 7. Jensen JJ, Kiilerich S: A case of adiposis dolorosa–Dercum’s disease. Ugeskr Laeger 1991, 153:3564. 8. Tiesmeier J, Warnecke H, Schuppert F: An uncommon cause of recurrent abdominal pain in a 63-year-old obese woman. Dtsch Med Wochenschr 2006, 131:434–437. 9. Pimenta WP, Paula FJ, Dick-de-Paula I, Piccinato CE, Monteiro CM, Brandao-Neto J, Kettelhut IC, Foss MC: Hormonal and metabolic study of a case of adiposis dolorosa (Dercum’s disease). Braz J Med Biol Res 1992, 25:889–893. 10. Palmer ED: Dercum’s disease: adiposis dolorosa. Am Fam Physician 1981, 24:155–157. 11. Hansson E, Svensson H, Brorson H: Review of Dercum’s disease and proposal of diagnostic criteria, diagnostic. methods, classification and management Orphanet Journal of Rare Diseases 2012, 7:23 doi:10.1186/1750-1172-7-23