Obesity and psychopathology are common in children with hypothalamic/chiasmatic gliomas (HCG) and craniopharyngiomas (CR).
The aims of this study include: (1) To treat tumor-related obesity with combined pharmacologic therapy (phentermine with dl-fenfluramine or fluoxetine) and behavior modification; (2) To assess metabolism and body weight; and (3) To establish standard psychiatric diagnoses in this population. Methods used included: Anthroprometric assessment, bone density, body composition, resting and total energy expenditure with doubly labeled water and the diagnostic interview for children and adolescents (DICA), a structured psychiatric interview were completed. From March 1997 to September 1997, the medications used were dl- fenfluramine and phentermine. Five patients were enrolled and treated for greater than three months. All patients were between 165% to 243% of ideal body weight (IBW). Weight loss ranged from 2.9kg-13.2kg (mean = 7.5 kg). There was no significant toxicity and all echocardiograms were normal. All 5 patients fulfilled the criteria for both major depressive disorder or mood disorder, depressed type and post traumatic stress disorder. Four patients had secondary ADHD and 3 had generalized anxiety disorder. Only 1 patient had either pre-morbid obesity and pre-morbid psychiatric diagnosis. The FDA removed dl-fenfluramine from the market and this protocol was changed to the use of prozac and phentermine in November of 1997. Three new patients have been enrolled and treated for three months. These patients are between 160% and 255% of IBW. Thus far, weight loss has ranged from 4.1kg - 5.9kg (mean = 5kg). There has been no significant toxicity and all echocardiograms are normal. The study is expected to have 26 participants. Currently, active recruitment is underway. To date, conclusions include: (1) Weight loss is possible in children with morbid obesity due to hypothalamic/chiasmatic gliomas and craniopharyngiomas with combined pharmacologic and behavioral management. (2) The incidence of multiple psychiatric diagnoses is high and warrants further investigation and appropriate treatment strategies.

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Children's Hospital of Philadelphia
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Medina-Gomez, Carolina; Kemp, John P; Dimou, Niki L et al. (2017) Bivariate genome-wide association meta-analysis of pediatric musculoskeletal traits reveals pleiotropic effects at the SREBF1/TOM1L2 locus. Nat Commun 8:121
Agopian, A J; Goldmuntz, Elizabeth; Hakonarson, Hakon et al. (2017) Genome-Wide Association Studies and Meta-Analyses for Congenital Heart Defects. Circ Cardiovasc Genet 10:e001449
Ruan, Alexandra; Tobin, Nicole H; Mulligan, Kathleen et al. (2016) Brief Report: Macrophage Activation in HIV-Infected Adolescent Males Contributes to Differential Bone Loss by Sex: Adolescent Trials Network Study 021. J Acquir Immune Defic Syndr 72:372-5
Medoff-Cooper, Barbara; Irving, Sharon Y; Hanlon, Alexandra L et al. (2016) The Association among Feeding Mode, Growth, and Developmental Outcomes in Infants with Complex Congenital Heart Disease at 6 and 12 Months of Age. J Pediatr 169:154-9.e1
Ollberding, Nicholas J; Gilsanz, Vicente; Lappe, Joan M et al. (2015) Reproducibility and intermethod reliability of a calcium food frequency questionnaire for use in Hispanic, non-Hispanic Black, and non-Hispanic White youth. J Acad Nutr Diet 115:519-27.e2
Medina-Gómez, Carolina; Chesi, Alessandra; Heppe, Denise H M et al. (2015) BMD Loci Contribute to Ethnic and Developmental Differences in Skeletal Fragility across Populations: Assessment of Evolutionary Selection Pressures. Mol Biol Evol 32:2961-72
Avitabile, Catherine M; Goldberg, David J; Zemel, Babette S et al. (2015) Deficits in bone density and structure in children and young adults following Fontan palliation. Bone 77:12-6
Rutstein, Richard M; Samson, Pearl; Fenton, Terry et al. (2015) Long-term safety and efficacy of atazanavir-based therapy in HIV-infected infants, children and adolescents: the Pediatric AIDS Clinical Trials Group Protocol 1020A. Pediatr Infect Dis J 34:162-7
Trabulsi, Jillian C; Irving, S Y; Papas, M A et al. (2015) Total Energy Expenditure of Infants with Congenital Heart Disease Who Have Undergone Surgical Intervention. Pediatr Cardiol 36:1670-9
Lappe, Joan M; Watson, Patrice; Gilsanz, Vicente et al. (2015) The longitudinal effects of physical activity and dietary calcium on bone mass accrual across stages of pubertal development. J Bone Miner Res 30:156-64

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