Semaglutide Treatment in a Patient with Extreme Obesity and Massive Lymphedema: A Case Report.

IF 3.9 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Obesity Facts Pub Date : 2024-09-09 DOI:10.1159/000540241

Joanne Thanh-Tâm Nguyen,Marie-Amélie Barbet-Massin,Emilie Pupier,Alice Larroumet,Laurène Bosc,Marie Michelet,Maud Monsaingeon-Henry,Blandine Gatta-Cherifi

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Abstract

INTRODUCTION Extreme obesity (BMI ≥ 50 kg/m2) is a complex pathology to treat. One of the complications of extreme obesity is massive localized lymphedema (MLL), due to compromised lymphatic drainage. There is a lack of literature guiding the medical management of these conditions. CASE PRESENTATION We present a 43-year-old male who was admitted to our specialized obesity center for weight management. His initial weight was 255 kg and BMI, 93.7 kg/m2. He suffered from massive multifocal lymphedema of his left leg. He was bedridden due to his condition and malnourished, as shown by multiple vitamin deficiencies. The patient received care from our multidisciplinary team including nurses, dieticians, physical therapists, and psychologists. Treatment with semaglutide was started in hospital and continued at home. The maximal dose used was 1 mg/week but decreased during follow-up to 0.25 mg/week to avoid malnutrition. Protein and nutritional supplements were added. At 28 weeks of therapy, the patient had lost 40 kg or 15.7% of his total body weight (TBW). His lymphedema decreased; he had lost at least 16 cm of his left thigh circumference. He was able to walk again and regain autonomy of his daily activities of living. CONCLUSION Semaglutide can be effective in patients with extreme obesity, with the support of a multidisciplinary team in a specialized obesity center. It can also help decrease MLL. More data is needed to guide medical treatment of patients with extreme obesity and MLL.

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塞马鲁肽治疗极度肥胖和大面积淋巴水肿患者：病例报告。

简介极度肥胖（体重指数≥ 50 kg/m2）是一种复杂的病理治疗方法。极度肥胖的并发症之一是局部淋巴水肿（MLL），这是由于淋巴引流受阻所致。目前还缺乏指导这些病症医疗管理的文献。病例介绍我们为大家介绍一位 43 岁的男性患者，他因体重控制问题住进了我们的肥胖症专科中心。他的初始体重为 255 千克，体重指数（BMI）为 93.7 千克/平方米。他的左腿患有大面积多灶性淋巴水肿。由于病情严重，他卧床不起，而且营养不良，表现为多种维生素缺乏。我们的多学科团队（包括护士、营养师、理疗师和心理学家）为患者提供了护理。患者在医院开始接受塞马鲁肽治疗，并在家中继续接受治疗。最大剂量为 1 毫克/周，但在随访期间降至 0.25 毫克/周，以避免营养不良。此外还添加了蛋白质和营养补充剂。治疗 28 周后，患者体重减轻了 40 公斤，占总重量的 15.7%。他的淋巴水肿有所减轻；左大腿周长至少减少了 16 厘米。结论在专业肥胖症中心多学科团队的支持下，美格鲁肽对极度肥胖症患者有效。结论：在肥胖症专科中心多学科团队的支持下，美格鲁肽对极度肥胖症患者是有效的，它还有助于减少 MLL。还需要更多数据来指导对极度肥胖和 MLL 患者的治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Obesity Facts 医学-内分泌学与代谢

CiteScore

6.80

自引率

5.60%

发文量

审稿时长

6-12 weeks

期刊介绍： ''Obesity Facts'' publishes articles covering all aspects of obesity, in particular epidemiology, etiology and pathogenesis, treatment, and the prevention of adiposity. As obesity is related to many disease processes, the journal is also dedicated to all topics pertaining to comorbidity and covers psychological and sociocultural aspects as well as influences of nutrition and exercise on body weight. The editors carefully select papers to present only the most recent findings in clinical practice and research. All professionals concerned with obesity issues will find this journal a most valuable update to keep them abreast of the latest scientific developments.