A Case of Prader-Willi Syndrome With Recurrent Episodes of Heart Failure Due to Weight Gain, Successfully Treated With Low-dose Semaglutide

Abstract

Prader-Willi syndrome (PWS) is a congenital anomaly of the hypothalamus that leads to overeating and severe obesity, and is associated with a high rate of type 2 diabetes. In this case, a patient with PWS who had repeated hospitalizations for heart failure with a preserved ejection fraction due to severe obesity (BMI 43.8 kg/m2) and poor glycemic control was started on semaglutide (0.25 mg, subcutaneous injections, once a week). After 4 months of treatment, the patient’s body weight had decreased 19 kg from 108 kg (before treatment) to 89 kg, and their HbA1c value had decreased 2.5 % from 8.2 % to 5.7 %. Although there are some reports on the use of glucagon-like peptide-1 receptor agonist (GLP-1RAs) for PWS because of its weight loss effect, no reports have demonstrated a significant effect of low-dose semaglutide, as was observed in this case. The present case suggests that GLP-1RA treatment may have the potential to improve the symptoms associated with heart failure.