UNASSIGNED: Nine months postoperatively the patient developed arm swelling and disability. While on adjuvant chemo and hormonal therapy, her weight increased dramatically and peaked 4 years later. Corresponding to her weight gain was significant worsening of her symptoms.
UNASSIGNED: Due to adjuvant cancer-related weight gain and inability to lose weight with diet and exercise, she was referred for evaluation and diagnosed with lymphedema. The patient started treatment with a Glucagon-like peptide 1 receptor agonist and lost 24% of her body weight over the next 13 months. The improvement in her lymphedema mirrored her weight loss. Her limb volume difference dropped from 10.3% down to 3.4% and she no longer required a compression garment. Her imaging demonstrated return of lymphatic pumping and she experienced a significant improvement in quality of life, assessed by a validated lymphedema-specific patient reported outcome (PROM). She remains on hormonal therapy, no longer needs compression and is back to regular exercise without impairment.
UNASSIGNED: GLP-1 RAs provide a potential medical option for many patients struggling with weight gain and lymphedema. We have observed by all objective measures a significant reduction in lymphedema and the elimination of compression in the case presented as a direct result of GLP-1 RA. This may also reduce a patient\'s BMI to the point where they become a good candidate for lymphovenous bypass or vascularized lymph node transplant when indicated.
■术后9个月,患者出现手臂肿胀和残疾。在进行辅助化疗和激素治疗时,她的体重急剧增加,4年后达到顶峰。与她的体重增加相对应的是她的症状的显著恶化。
■由于与癌症相关的辅助性体重增加以及无法通过饮食和运动来减肥,她被转诊接受评估,并被诊断患有淋巴水肿。患者开始使用胰高血糖素样肽1受体激动剂治疗,在接下来的13个月内体重下降了24%。淋巴水肿的改善反映了她的体重减轻。她的肢体体积差异从10.3%下降到3.4%,她不再需要压缩服。她的影像学表现为淋巴泵的恢复,并且生活质量得到了显着改善,由经过验证的淋巴水肿特异性患者报告的结果(PROM)评估。她还在接受荷尔蒙疗法,不再需要压缩,回到正常运动而没有损伤。
GLP-1RA为许多体重增加和淋巴水肿的患者提供了潜在的医疗选择。在GLP-1RA直接导致的情况下,我们通过所有客观措施观察到淋巴水肿的显着减少和压缩的消除。这也可能会降低患者的BMI,使其成为淋巴静脉搭桥或血管化淋巴结移植的良好候选者。