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Metabolic complications and their mechanisms in patients with craniopharyngioma

Erfurth, Eva Marie LU and Müller, Hermann L. (2025) In Best Practice and Research: Clinical Endocrinology and Metabolism
Abstract

After diagnosis of craniopharyngioma, patients frequently develop a rapid weight gain leading to morbid hypothalamic obesity due to disease- and/or treatment-associated hypothalamic lesions. Hypothalamic obesity should be diagnosed and treated in the context of hypothalamic syndrome. Hypothalamic syndrome includes neuroendocrine deficiencies, disruption of circadian rhythm, disturbed hunger-satiety and thirst feelings, temperature dysregulation, and neurocognitive, sleep and psychosocial behavioral problems. Long-term prognosis is frequently impaired by increased risk for metabolic syndrome, cardiovascular problems, severe impairments of health-related quality of life, and premature mortality. Treatment of hypothalamic syndrome is... (More)

After diagnosis of craniopharyngioma, patients frequently develop a rapid weight gain leading to morbid hypothalamic obesity due to disease- and/or treatment-associated hypothalamic lesions. Hypothalamic obesity should be diagnosed and treated in the context of hypothalamic syndrome. Hypothalamic syndrome includes neuroendocrine deficiencies, disruption of circadian rhythm, disturbed hunger-satiety and thirst feelings, temperature dysregulation, and neurocognitive, sleep and psychosocial behavioral problems. Long-term prognosis is frequently impaired by increased risk for metabolic syndrome, cardiovascular problems, severe impairments of health-related quality of life, and premature mortality. Treatment of hypothalamic syndrome is challenging. Recently, an algorithm for personalized, risk-specific treatment of hypothalamic syndrome has been published. Dextro-amphetamines and other central stimulating agents as well as glucagon-like peptide-1 receptor (GLP-1R) agonists may cause weight loss. Bariatric surgery is effective. However, non-reversible procedures are controversial due to ethical and legal considerations in minors. Hypothalamus-sparing treatment strategies and research on novel therapeutic agents for hypothalamic syndrome are warranted.

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publication status
epub
subject
keywords
craniopharyngioma, hypothalamus, metabolic syndrome, obesity, quality of life, sequelae
in
Best Practice and Research: Clinical Endocrinology and Metabolism
article number
101999
publisher
Elsevier
external identifiers
  • scopus:105003374675
  • pmid:40274451
ISSN
1521-690X
DOI
10.1016/j.beem.2025.101999
language
English
LU publication?
yes
id
d83f8f15-4901-41a3-8a20-96b7de6e1be6
date added to LUP
2025-09-18 12:51:26
date last changed
2025-10-02 14:50:18
@article{d83f8f15-4901-41a3-8a20-96b7de6e1be6,
  abstract     = {{<p>After diagnosis of craniopharyngioma, patients frequently develop a rapid weight gain leading to morbid hypothalamic obesity due to disease- and/or treatment-associated hypothalamic lesions. Hypothalamic obesity should be diagnosed and treated in the context of hypothalamic syndrome. Hypothalamic syndrome includes neuroendocrine deficiencies, disruption of circadian rhythm, disturbed hunger-satiety and thirst feelings, temperature dysregulation, and neurocognitive, sleep and psychosocial behavioral problems. Long-term prognosis is frequently impaired by increased risk for metabolic syndrome, cardiovascular problems, severe impairments of health-related quality of life, and premature mortality. Treatment of hypothalamic syndrome is challenging. Recently, an algorithm for personalized, risk-specific treatment of hypothalamic syndrome has been published. Dextro-amphetamines and other central stimulating agents as well as glucagon-like peptide-1 receptor (GLP-1R) agonists may cause weight loss. Bariatric surgery is effective. However, non-reversible procedures are controversial due to ethical and legal considerations in minors. Hypothalamus-sparing treatment strategies and research on novel therapeutic agents for hypothalamic syndrome are warranted.</p>}},
  author       = {{Erfurth, Eva Marie and Müller, Hermann L.}},
  issn         = {{1521-690X}},
  keywords     = {{craniopharyngioma; hypothalamus; metabolic syndrome; obesity; quality of life; sequelae}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Best Practice and Research: Clinical Endocrinology and Metabolism}},
  title        = {{Metabolic complications and their mechanisms in patients with craniopharyngioma}},
  url          = {{http://dx.doi.org/10.1016/j.beem.2025.101999}},
  doi          = {{10.1016/j.beem.2025.101999}},
  year         = {{2025}},
}