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The pathogenetic mechanisms underlying this syndrome include disruption of hunger/satiety centers (damage to arcuate, ventromedial, and paraventricular hypothalamic nuclei), leptin resistance despite elevated circulating leptin levels, autonomic dysregulation with reduced energy expenditure, hypothalamic-pituitary axis dysfunction, and local inflammatory processes [87, 88]

If there is clinical improvement and if a reticulocyte response is observed, the same amount may be given on alternate days for seven doses, then every three to four days for another two to three weeks

A nonsteroidal cream called a topical calcineurin inhibitor (TCI) that controls your body's immune response can also help prevent itching

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