title: Successful methylphenidate treatment of early onset extreme obesity in a child with a melanocortin-4 receptor gene mutation and attention deficit/hyperactivity disorder.
abstract: We present the case report of a 2 year old boy with early onset extreme obesity (body mass index (BMI) 34.2 kg/m²; body mass index standard deviation score (BMI-SDS) 5.4) who is heterozygous for a non-conservative functionally relevant melanocortin MC(4)receptor mutation (Glu308Lys) and who also showed severe symptoms of attention deficit/hyperactivity disorder (ADHD). Treatment with the stimulant methylphenidate led to a sharp decrease of BMI to 21.8 kg/m² (BMI-SDS 2.8) within 24 months. We discuss potential mechanisms for this unusually large weight loss and suggest a potential link between the melanocortinergic and the dopaminergic systems, and the sympathetic nervous system. The potential benefit of methylphenidate in obese melanocortin MC(4)receptor mutation carriers with and without co-morbid ADHD warrants further studies.
authors.affiliation: Department of Child and Adolescent Psychiatry, University of Duisburg-Essen, Virchowstr. 174, D - 45147 Essen, Germany. oezguer.albayrak@uni-due.de
authors.forename: Ozgür
authors.initials: O
authors.lastname: Albayrak
authors.forename: Beate
authors.initials: B
authors.lastname: Albrecht
authors.forename: Susann
authors.initials: S
authors.lastname: Scherag
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Barth
authors.forename: Anke
authors.initials: A
authors.lastname: Hinney
authors.forename: Johannes
authors.initials: J
authors.lastname: Hebebrand
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications*; D002675:Child, Preschool; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use*; D009154:Mutation; D009765:Obesity / Q000150:complications* / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D044105:Receptor, Melanocortin, Type 4 / Q000235:genetics*
chemical_list: D044105:Receptor, Melanocortin, Type 4; D008774:Methylphenidate