Berardinelli-Seip congenital lipodystrophy (BSCL) is an uncommon autosomal 
recessive disorder. Patients with BSCL present with a distinct phenotype since 
subcutaneous fat is largely lacking and musculature has become more prominent. 
During childhood, diabetes and acanthosis nigricans evolve and female patients 
may develop hirsutism. Different genes encoding this entity have been described. 
Achalasia is a rare esophageal motility disorder, characterized by its distinct 
motility pattern with absent or incomplete lower esophageal sphincter (LES) 
relaxations. The exact cause of achalasia is yet unknown. Here, we describe a 
patient with achalasia in the context of BSCL, which might be linked by a shared 
pathophysiologic background, as evaluated in this case report.
CONCLUSION: In a BSCL patient presenting with gastrointestinal symptoms, a 
motility disorder of the gastrointestinal tract should be considered.
WHAT IS KNOWN: • Berardinelli-Seip congenital lipodystrophy (BSCL) and achalasia 
are both disorders characterized by low prevalence. What is New: • Co-existence 
of both diseases is described in this report. Linkage by a potential common 
pathophysiologic background is discussed in this paper.