Gastric bypass surgery for treatment of hypothalamic obesity after craniopharyngioma therapy View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2007-08

AUTHORS

Thomas H Inge, Paul Pfluger, Meg Zeller, Susan R Rose, Lukas Burget, Sumana Sundararajan, Stephen R Daniels, Matthias H Tschöp

ABSTRACT

BACKGROUND: A 14-year-old boy presented with daytime somnolence, intermittent emesis and hypothyroidism. Neuroimaging revealed a calcified suprasellar intracranial mass, suspected to be a craniopharyngioma. Subtotal resection of the tumor confirmed the diagnosis. Extreme obesity (BMI >60 kg/m(2)) and hyperinsulinemia followed tumor resection and cranial irradiation. Dietary interventions were unsuccessful, and pharmacologic intervention (i.e. octreotide) only slowed the rate of weight gain. INVESTIGATIONS: Radiography documented the suprasellar mass. Following surgical resection and radiotherapy, hypothalamic-pituitary deficiencies were found. Preprandial and postprandial excursions of insulin, active ghrelin and leptin were measured before and after gastric bypass surgery. DIAGNOSIS: Panhypopituitarism, hypothalamic obesity and hyperinsulinemia following craniopharyngioma therapy. MANAGEMENT: Severe caloric restriction, octreotide, and pituitary hormone replacement did not produce weight loss. Gastric bypass surgery led to reduced food cravings, significant weight loss, and amelioration of obesity-related comorbidities. Correction of fasting hyperinsulinemia, normalization of postprandial insulin responses, and reductions in active ghrelin and leptin concentrations were also observed. More... »

PAGES

606-609

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1038/ncpendmet0579

DOI

http://dx.doi.org/10.1038/ncpendmet0579

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1014431841

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/17643131


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