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Successful rapid weight reduction and the use of liraglutide for morbid obesity in adolescent Prader-Willi syndrome

Annals of Pediatric Endocrinology & Metabolism 2020년 25권 1호 p.52 ~ 56
김유미, 이연주, 김수연, 전종근, 임한혁,
소속 상세정보
김유미 ( Kim Yoo-Mi ) - Chungnam National University College of Medicine Chungnam National University Hospital Department of Pediatrics
이연주 ( Lee Yeoun-Joo ) - Pusan National University School of Medicine Pusan National University Children’s Hospital Department of Pediatrics
김수연 ( Kim Soo-Yeon ) - Pusan National University School of Medicine Pusan National University Children’s Hospital Department of Rehabilitation
전종근 ( Cheon Chong-Kun ) - Pusan National University School of Medicine Pusan National University Children’s Hospital Department of Pediatrics
임한혁 ( Lim Han-Hyuk ) - Chungnam National University College of Medicine Chungnam National University Hospital Department of Pediatrics

Abstract


Prader-Willi syndrome (PWS), an imprinting disorder, results from the loss of expression of a paternal gene on chromosome 15q11-q13. Progressive obesity and its associated complications lead to increased morbidity and early death in PWS patients. The management techniques available for morbid obesity in adolescents and adults with PWS are limited. Herein, we report successful weight reduction in an adolescent PWS case showing morbid obesity and respiratory failure. An 18-year-old girl with PWS presented with diffuse cellulitis and dyspnea due to severe obesity. Her body weight had increased from 146 to 161 kg despite dietary restriction to 800 kcal/day, and a mechanical ventilator was required for dyspnea. During mechanical ventilation, the patient was managed using diuretics and by restricting fluid intake; her daily calorie intake was reduced to 200 kcal. This aggressive calorie and water restriction continued for 3 weeks and reduced her body weight to 118.6 kg. After transfer to the general ward, the patient was provided with growth hormone therapy and intensive aquatic rehabilitation and was administered liraglutide; as a result, her weight further decreased to 104 kg (body mass index [BMI], 50.8 kg/m2), and she was discharged. Following discharge, she maintained her BMI and adapted to 1,000 kcal/day for 1 year. Aggressive water and calorie restriction were observed as an effective method for rapid weight reduction in PWS patients, and liraglutide appeared useful in maintaining weight reduction in adolescent and adult PWS.

키워드

Liraglutide; Prader-Willi syndrome; Adolescent; Obesity; Morbid

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