| Gastric bypass surgery for treatment of hypothalamic obesity after craniopharyngioma therapy. | |
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MedLine Citation:
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PMID: 17643131 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Thomas H Inge; Paul Pfluger; Meg Zeller; Susan R Rose; Lukas Burget; Sumana Sundararajan; Stephen R Daniels; Matthias H Tschöp |
Publication Detail:
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Type: Case Reports; Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Nature clinical practice. Endocrinology & metabolism Volume: 3 ISSN: 1745-8374 ISO Abbreviation: - Publication Date: 2007 Aug |
Date Detail:
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Created Date: 2007-07-23 Completed Date: 2007-08-09 Revised Date: 2007-12-03 |
Medline Journal Info:
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Nlm Unique ID: 101261798 Medline TA: Nat Clin Pract Endocrinol Metab Country: England |
Other Details:
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Languages: eng Pagination: 606-9 Citation Subset: IM |
Affiliation:
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Division of Pediatric General and Thoracic Surgery, ML 2023, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA. thomas.inge@cchmc.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Combined Modality Therapy / adverse effects Craniopharyngioma / therapy* Gastric Bypass / methods* Humans Hyperinsulinism / etiology, physiopathology Hypopituitarism / etiology, physiopathology Hypothalamic Diseases / complications*, etiology Male Obesity / etiology*, physiopathology, surgery* Pituitary Neoplasms / therapy* |
| Grant Support | |
ID/Acronym/Agency:
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M01 RR 08084/RR/NCRR NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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