Laparoscopic sleeve gastrectomy for morbid obesity and Klinefelter syndrome: clinical report on two patients, with long-term follow-up

Introduction Klinefelter syndrome (KS) can appear as a wide spectrum of clinical manifestations, with no guidelines for appropriate treatment. We present the first study of bariatric surgery (BS) with a 48-month follow-up, for the management of two patients affected by obesity and KS. Cases presentation The first patient was a 32-year-old man with diagnosis of Klinefelter mosaicism (46 XY/47, XXY), Body Mass Index (BMI) of 50 kg/m 2 , metabolic syndrome and Binge Eating Disorder (BED). He underwent a Laparoscopic Sleeve Gastrectomy (LSG) with weight loss (BMI = 38 kg/m 2 ) and improvements to his metabolic profile at 48 months. The second patient was a 44-year-old man with KS (47, XXY), BMI of 49 kg/m 2 , Obstructive Sleep Apnea Syndrome and BED. He underwent a banded LSG. After 48 months, he showed a satisfactory weight loss (BMI = 32 kg/m 2 ) and amelioration of comorbidities. Conclusion In patients with KS, LSG demonstrated long-term beneficial effects for weight loss and amelioration of comorbidities. An interdisciplinary approach is mandatory, since it leads to adherence to follow-up programs and mental health well-being.