Key result
Nutritional rehabilitation drives 40-pound weight gain and resolves cortical atrophy in severe anorexia nervosa.
Why the study?
Severe anorexia nervosa with extreme low BMI and associated complications including pericardial tamponade and cortical atrophy is rarely reported.
Case Report (n=1)
Suggests cortical atrophy may reverse with refeeding in anorexia; hypothesis-generating and needs prospective confirmation.
This case report describes a 20-year-old man with a severe presentation of anorexia nervosa. His case is unique in that he presented at 49% of his ideal body weight and had a body mass index (BMI) of 11.59. In addition, he had cognitive slowing on exam and had cortical atrophy on a head CT. Other medical complications included pericardial tamponade that was treated with an open window pericardiocentesis, hepatitis, and anemia. He was treated nutritionally, first with a Dobb-Hoff tube and then with oral feedings, as well as had group, individual, and family therapies. He responded well to treatment, his labs normalized and he was discharged at 75% of his ideal body weight after a weight increase of 40 pounds and after 106 days of hospitalization at our facility. In addition, a head CT was repeated and the cortical atrophy had resolved.
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Shapiro et al. (2014) conducted a case report in Severe anorexia nervosa (n=1). Nutritional rehabilitation and therapy was evaluated on Clinical recovery (weight gain, resolution of cortical atrophy and lab abnormalities). Nutritional rehabilitation and therapy over 106 days in a 20-year-old male with severe anorexia nervosa led to a 40-pound weight gain and resolution of cortical atrophy.
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