[Sarcoidosis and obesity].
BACKGROUND
Polypliagia and morbid obesity appears in patients with sarcodosis may be signs of neurosarcoidosis in the medial hypothalmus where satiety center is located. It is estimated that about 1% of all patients with sarcoidosis may have sarcoidosis of the hxpothalamus. It is of utmost importance to diagnose and treat hxpothalamie sarcoidosis as early as possible, because lethality from neurosarcoidosis is active as high (10%) as the lethality from other localizations of sarcoidasis (5%).
In a unique case report published so far, sarcoid granulomas were found by computerized tomography in the ventromedial hypothalamic nuclei of a 21-year-old man with a 7-year history of polyphagia and body mass index of 65.8. Another case report is of a 7-year-old boy with hyperphagia and obesity following an episode of meningoencephalitis, who presented with high Polypliagia insulin levels (1183 pmol/L) and strikingly high insulin release in response to glucose (7892 pmol/L) which were not accompanied by hypoglycemia. DISCUSSION AND CLUSION: These results have been supported withi experimental studies in animals. Cell groups of the medial hypothalamus are key to the regulation of energy balance. Functional disruption by colchicine injected in the hypothalamic arcuate, paraventricullar, and ventromedial cell groups produced increased food intake and obesity. After scanning, thiogliucose labeled with gold-198 (Au-198) at doses of 2 OmicroCi per patient, can be used to diagnose hypothalamic obesity in people with neurosarcoidosis, due to the ability of cell groups in hypothalamic satiety centers to take up thioglucose in their gluxcostat receptors.
Belojević
Goran
G
Medicinski fakultet Univerziteta u Beogradu, Institut za higijenu i medicinsku ekologiju.
Marić-Zivković
Jasmina
J
D000328:Adult; D000818:Animals; D002648:Child; D006801:Humans; D006963:Hyperphagia / Q000209:etiology*; D007027:Hypothalamic Diseases / Q000150:complications*; D008297:Male; D009765:Obesity / Q000209:etiology*; D012507:Sarcoidosis / Q000150:complications*