Obesity due to leukemic involvement of the hypothalamus may be the first manifestation of central nervous system (CNS) relapse. Hypothalamic syndrome may precede the appearance of lymphoblasts in the cerebrospinal fluid by a few months. We report a case of an 8-year-old girl with acute lymphoblastic leukemia who developed obesity, which was the first symptom of CNS relapse. A second remission and weight loss was achieved after intensive treatment.
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