title: Treatment with glucagon-like Peptide-1 agonist exendin-4 in a patient with hypothalamic obesity secondary to intracranial tumor.
abstract: OBJECTIVE
  Patients with hypothalamic tumors frequently experience severe obesity, and its treatment with diet, exercise, and/or pharmacologic treatment has had limited effect. Glucagon-like peptide-1 agonist exenatide (exendin-4), used for treatment of type 2 diabetes, causes persistent weight loss via signaling in the brainstem.
  
  
  METHODS
  We report the case of a 17-year-old patient with obesity resulting from a hypothalamic germ cell tumor. He was treated by chemoradiotherapy and exenatide at a dose of 5 µg subcutaneously twice daily.
  
  
  RESULTS
  Exenatide resulted in a 29-kg weight loss (BMI reduction from 37.1 to 29.1) after 2.5 years of treatment; significant weight gain occurred shortly after exenatide was discontinued.
  
  
  CONCLUSIONS
  Exenatide resulted in considerable reduction of body weight in a patient with severe hypothalamic obesity. This novel observation requires follow-up clinical studies for establishing the effects of exenatide in patients with disrupted hypothalamic energy regulatory pathways.
authors: Division of Endocrinology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn., USA.
authors: Jill H
authors: JH
authors: Simmons
authors: Ashley H
authors: AH
authors: Shoemaker
authors: Christian L
authors: CL
authors: Roth
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000150:complications* / Q000188:drug therapy; D000077270:Exenatide; D052216:Glucagon-Like Peptide 1 / Q000819:agonists; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007029:Hypothalamic Neoplasms / Q000150:complications / Q000188:drug therapy; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000150:complications* / Q000188:drug therapy; D009765:Obesity / Q000188:drug therapy* / Q000209:etiology*; D010455:Peptides / Q000627:therapeutic use*; D014688:Venoms / Q000627:therapeutic use*
chemical_list: D007004:Hypoglycemic Agents; D010455:Peptides; D014688:Venoms; D052216:Glucagon-Like Peptide 1; D000077270:Exenatide