The Narrative of a Patient with Leptin Receptor Deficiency: Personalized Medicine for a Rare Genetic Obesity Disorder.


Journal

Obesity facts
ISSN: 1662-4033
Titre abrégé: Obes Facts
Pays: Switzerland
ID NLM: 101469429

Informations de publication

Date de publication:
2023
Historique:
received: 25 01 2023
accepted: 05 06 2023
medline: 30 10 2023
pubmed: 3 7 2023
entrez: 2 7 2023
Statut: ppublish

Résumé

Leptin receptor (LEPR) deficiency is a rare genetic disorder that affects the body's ability to regulate appetite and weight. For patients and their families, the disorder seriously disrupts daily life; however, little is published about this impact. We here report the experiences of a 10.5-year-old girl with leptin receptor deficiency and her family. The diagnosis of this rare genetic obesity had a deep impact on the life of the child and her family. It led to a better understanding of the cause of the impaired appetite regulation and early-onset obesity with subsequently less judgement by others and improved cooperation of their social network and school on maintaining a healthy lifestyle for this girl. A strict eating regimen and lifestyle measures resulted in the first year after diagnosis in a significantly decreased body mass index (BMI), followed by BMI stabilization, still categorized as obesity class three. However, the troublesome challenge of how to manage the disruptive behaviour due to hyperphagia remained. Eventually, due to treatment with targeted pharmacotherapy, i.e., melanocortin-4 receptor agonists, her BMI continued to decrease due to resolving hyperphagia. The daily routine of the family and the atmosphere at home positively changed as they were no longer dominated by the food-focused behaviour of the child and the adherence to the strict eating regimen. This case report demonstrates the importance and impact of a rare genetic obesity disorder diagnosis in a family. Additionally, it highlights the value of genetic testing in patients with a high suspicion of a genetic obesity disorder as it can eventually lead to personalized treatment, such as guidance by specialized healthcare professionals and educated caregivers or targeted pharmacotherapy.

Identifiants

pubmed: 37393902
pii: 000531529
doi: 10.1159/000531529
pmc: PMC10601614
doi:

Substances chimiques

Receptors, Leptin 0
Leptin 0
Receptor, Melanocortin, Type 4 0

Types de publication

Case Reports

Langues

eng

Sous-ensembles de citation

IM

Pagination

514-518

Informations de copyright

© 2023 The Author(s). Published by S. Karger AG, Basel.

Références

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Auteurs

Mila S Welling (MS)

Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Division of Endocrinology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands.

Lotte Kleinendorst (L)

Department of Human Genetics, Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands, l.kleinendorst@amsterdamumc.nl.
Emma Center for Personalized Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands, l.kleinendorst@amsterdamumc.nl.

Mieke M van Haelst (MM)

Department of Human Genetics, Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Emma Center for Personalized Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.

Erica L T van den Akker (ELT)

Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Division of Endocrinology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands.

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Classifications MeSH