Could this be an endorine related problem?

[Nic306]

My son is currently 6 years old.  He was born 10 pounds 8 ounces, 22 1/2 inches long.   He had feeding difficulty as an infant and was gross motor delayed as he has hypotonia caused by an unknown source. The hypotonia has affected all gross motor including his mouth.  Also, as an infant, the front fontanelle was wide open until he was about 2, CT scan found nothing wrong with his head.  Around 3 years ago he developed a problem with weight gain.  Oddly enough, it seems that between the months of September and January he puts on an unexplainable large amount of weight.  For example, from January 07 to Sept. 07 he gained about 4 pounds.  But then from Sept 07 to January he went up another 10 pounds totaling 14 pounds for that year.  This has been happening consistantly for 3 years (that is as far back as I began to notice it, it could have been longer).  Also, during the months of extreme gaining, he goes through insomnia and night sweats.  His face appears swollen on some days and then not on others.  Also during the past few years he started to develop a dark patch (hyperpigmentation) on his upper left arm.  It has gradually grown bigger and now comes down from his shoulder to his elbow.  This summer it is now spreading upward over the shoulder and it looks as if a new patch is starting on the right arm as well.  We saw a nutrionist who said that she believes he may be insulin resistant.   We also saw an endocrinologist who told be that my son is just unlucky and that he cannot eat as much as everyone else without gaining.  I explained that he does not eat nearly a fraction of what most kids eat.  The doctor went on to say that while my son's BMI is currently too high, if I can keep it steady until he is 18 he will be ok then.  This doesn't seem right.  He is 71 pounds and eating less then 1000 cals.  His cortisol levels are normal and his TSH level was about 3.77 (I am going on memory).  Do you think I am waisting my time on another Endocrinologist's opinion?

[Nic306]

Hi, thank you for the suggestion.  He was already tested for Prader Willi Syndrome.  It was negative.

[Deanna L Aftab Guy, MD]

Rare but important to consider is Prader Willi Syndrome, these children inherit a genetic reason for their metabolism-often hypotonia at birth with failure to thrive, then become obese during toddler early preschool years with insatiable appetite, may be worth asking your doc