[Sarcoidosis and obesity].

Area of Science:

• Endocrinology and Metabolism
• Neurology
• Oncology

Context:

• Sarcoidosis is a multisystem inflammatory disease that can affect the central nervous system, including the hypothalamus.
• Hypothalamic sarcoidosis is rare, estimated in 1% of sarcoidosis patients, and can lead to significant hormonal and metabolic disturbances.
• Neurosarcoidosis carries a substantial mortality rate, emphasizing the need for timely diagnosis and intervention.

Purpose:

• To highlight the potential link between hypothalamic sarcoidosis and the development of polyphagia and morbid obesity.
• To present case reports illustrating hypothalamic sarcoidosis presenting with hyperphagia and obesity.
• To discuss the diagnostic utility of gold-198 thioglucose ([198Au]-thioglucose) imaging for hypothalamic obesity in neurosarcoidosis.

Summary:

• Polyphagia and morbid obesity in sarcoidosis patients may indicate neurosarcoidosis affecting the hypothalamic satiety centers.
• Case reports detail young patients with hypothalamic sarcoidosis presenting with severe hyperphagia, obesity, and altered insulin regulation.
• Experimental studies support the role of hypothalamic nuclei in energy balance regulation, with disruption leading to obesity.

Impact:

• Early identification of hypothalamic sarcoidosis is critical due to its high lethality.
• The findings suggest [198Au]-thioglucose imaging as a potential diagnostic tool for hypothalamic obesity in neurosarcoidosis.
• This research contributes to understanding the complex interplay between sarcoidosis, the hypothalamus, and metabolic dysfunction.