Table 3. Multidisciplinary team in treating ROHHADNET.

ROHHADNET = rapid-onset obesity with hypothalamic dysfunction, hypoventilation, autonomic dysregulation, and neuroendocrine tumor

Investigation/Screening	Therapeutic options
Rapid obesity
Initial clinical evaluation, brain MRI, complete endocrine workup to exclude other differential diagnosis of precautious puberty, and evaluation of metabolic disturbance/year	Body mass index stabilization using strict calorie intake and regular exercise. Antidiabetic drugs and antilipid drugs
Hypothalamic dysfunction
Hormonal investigation/Year for hypothyroidism, hyperprolactinemia, growth hormone deficiency, puberty delay, and adrenalin insufficiency	Specific hormonal substitution
Hypoventilation
Polysomnography with nocturnal gas exchange/year if negative in the first five years, and prevention of respiratory infection	Artificial ventilation and influenza vaccine/year
Autonomic dysregulation
ECG, echocardiography, 72-hour Holter/year, blood pressure/three months, gastroenterology screening/year for celiac disease, food intolerance and transient dysregulation, and ophthalmologic evaluation/year	Cardiac pacemaker, antihypertensive drugs, gluten-free diet, lactose-free diet, and drugs for transient control
Neural Tumor
Screening to detect neuroendocrine tumors, and chest and abdominal MRI/year	In case of neuroendocrine tumor: staging and treatment
Neurologic Impact
Electroencephalography in case of seizure, and evaluation for behavioral disturbances.	Antiepileptic drugs and antipsychotic drugs
Genetic considerations
Exclude a PHOX2B mutation and genetic obesity