{
  "id": "SCR-LIP-000018",
  "statement": "Secondary lymphedema (lipolymphedema) can develop as a complication of advanced lipedema due to chronic lymphatic overload, with lymph stasis becoming more evident at advanced disease stages.",
  "statement_pt": "O linfedema secundário (lipolinfedema) pode surgir como complicação do lipedema avançado por sobrecarga linfática crônica, com a estase linfática tornando-se mais evidente nos estágios avançados.",
  "claim_type": "clinical_association",
  "context": {
    "population": "patients with advanced lipedema",
    "condition": "lipedema",
    "exposure": "advanced/chronic lipedema",
    "comparator": "early-stage lipedema",
    "outcome": "secondary lymphedema (lipolymphedema) / lymph stasis",
    "scope": "disease progression (consensus)"
  },
  "knowledge_state": "probable",
  "evidence_confidence": "low",
  "evidence": [
    {
      "ref": "DOI:10.1590/1677-5449.202301832",
      "stance": "supporting",
      "study_design": "consensus",
      "n": 113,
      "risk_of_bias": "moderate",
      "year": 2025,
      "amato_authored": true,
      "note": "consensus: lipolymphedema as a complication 3.95 (level B); lymph stasis more evident in advanced stages 4.36"
    }
  ],
  "relations": [
    {
      "type": "co_occurs",
      "target_hint": "lymphedema / lipolymphedema"
    }
  ],
  "gaps": "Lymphatic dysfunction in early lipedema is debated; statement is consensus-level (level B/C), not from longitudinal imaging.",
  "primary_amato_source": "DOI:10.1590/1677-5449.202301832",
  "curators": [
    {
      "name": "Alexandre C. M. Amato",
      "orcid": "0000-0003-4008-4029",
      "role": "lead_curator"
    }
  ],
  "created": "2026-05-30",
  "updated": "2026-05-30",
  "license": "CC-BY-4.0",
  "answers_questions": [
    {
      "id": "SQ-LIP-000017",
      "role": "supporting",
      "question": "Does lipedema progress to lymphedema and cause functional disability?",
      "url": "https://scientificclaims.org/q/SQ-LIP-000017.html"
    }
  ],
  "url": "https://scientificclaims.org/c/SCR-LIP-000018.html"
}