Case 21-2012: A 27-year-old man with fatigue, weakness, weight loss, and decreased libido

New England Journal of Medicine

Volumn 367, Issue 2, 2012, Pages 157-169

  Hunt, Daniel P ^a,b   Becker, Anne E ^a,b   Guimaraes, Alexander R ^a,b   Stemmer Rachamimov, Anat ^a,b   Misdraji, Joseph ^a,b  

^a MASSACHUSETTS GENERAL HOSPITAL   (United States)

^b HARVARD MEDICAL SCHOOL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ANTINUCLEAR ANTIBODY; GABAPENTIN; LIPOFUSCIN; MORPHINE SULFATE; SALBUTAMOL; TESTOSTERONE; AMINOTRANSFERASE;

ABDOMINAL PAIN; ADULT; ANKLE EDEMA; ANOREXIA NERVOSA; ARTICLE; ASTHMA; BLEEDING; BODY MASS; CACHEXIA; CASE REPORT; COMPUTER ASSISTED TOMOGRAPHY; CONSTIPATION; DECUBITUS; DENTITION; DIFFERENTIAL DIAGNOSIS; DSM-IV; EATING DISORDER; EATING DISORDER NOT OTHERWISE SPECIFIED; ELECTRON MICROSCOPY; EMPHYSEMA; FATIGUE; FOOT EDEMA; GASTROCNEMIUS MUSCLE; HUMAN; HUMAN TISSUE; INFARCTION; INFLAMMATION; JAUNDICE; JAW DISEASE; LEG EDEMA; LIBIDO; LIVER BIOPSY; LIVER DYSFUNCTION; LIVER HEMOSIDEROSIS; LYMPH NODE BIOPSY; MALE; MALNUTRITION; MONONEUROPATHY; MORPHEA; MUSCLE DISEASE; NECROSIS; NERVE BIOPSY; NUCLEAR MAGNETIC RESONANCE IMAGING; NUTRITIONAL ASSESSMENT; OBESITY; PAIN; PETECHIA; PHYSICAL EXAMINATION; PNEUMOMEDIASTINUM; PRIMARY MEDICAL CARE; PRIORITY JOURNAL; REFEEDING; REHABILITATION CARE; SKIN BIOPSY; SKIN LUPUS ERYTHEMATOSUS; STARVATION; SUBMANDIBULAR ABSCESS; TESTIS DISEASE; WEAKNESS; WEIGHT REDUCTION; BLOOD; CLINICAL OBSERVATION; CLINICAL STUDY; DIAGNOSIS; LIVER; LIVER DISEASE; MUSCLE WEAKNESS; PATHOLOGY; PSYCHOLOGICAL ASPECT; RADIOGRAPHY; SKELETAL MUSCLE; SKIN; SURAL NERVE;

ADULT; ANOREXIA NERVOSA; DIAGNOSIS, DIFFERENTIAL; EATING DISORDERS; FATIGUE; HUMANS; LIBIDO; LIVER; LIVER DISEASES; MALE; MALNUTRITION; MEDIASTINAL EMPHYSEMA; MUSCLE WEAKNESS; MUSCLE, SKELETAL; SKIN; SURAL NERVE; TOMOGRAPHY, X-RAY COMPUTED; TRANSAMINASES; WEIGHT LOSS;

EID: 84863658918     PISSN: 00284793     EISSN: 15334406     Source Type: Journal    
DOI: 10.1056/NEJMcpc1110053     Document Type: Article

References (34)

1. Al-Mufarrej F, Badar J, Gharagozloo F, Tempesta B, Strother E, Margolis M. Spontaneous pneumomediastinum: diagnostic and therapeutic interventions. J Cardiothorac Surg 2008;3:59.
2. Caceres M, Ali SZ, Braud R, Weiman D, Garrett HE Jr. Spontaneous pneumomediastinum: a comparative study and review of the literature. Ann Thorac Surg 2008;86:962-6.
3. Filosso PL, Garabello D, Lyberis P, Ruffini E, Oliaro A. Spontaneous pneumomediastinum: a rare complication of anorexia nervosa. J Thorac Cardiovasc Surg 2010;139(4):e79-e80.
4. Iyer VN, Joshi AY, Ryu JH. Spontaneous pneumomediastinum: analysis of 62 consecutive adult patients. Mayo Clin Proc 2009;84:417-21.
5. Karim A, Ahmed S, Rossoff L. Pneumomediastinum simulating a panic attack in a patient with anorexia nervosa. Int J Eat Disord 2003;33:104-7. (Pubitemid 36020248)
6. Miura H, Taira O, Hiraguri S, Ohtani K, Kato H. Clinical features of medical pneumomediastinum. Ann Thorac Cardiovasc Surg 2003;9:188-91.
7. Biffl WL, Narayanan V, Gaudiani JL, Mehler PS. The management of pneumothorax in patients with anorexia nervosa: a case report and review of the literature. Patient Saf Surg 2010;4:1.
8. Lin LY, Kwok CF, Tang KT, Ho LT, Lin HD. Diffuse soft tissue emphysema in anorexia nervosa: a case report. Int J Eat Disord 2005;38:277-80.
9. van Veelen I, Hogeman PH, van Elburg A, Nielsen-Abbring FW, Heggelman BG, Mahieu HF. Pneumomediastinum: a rare complication of anorexia nervosa in children and adolescents: a case study and review of the literature. Eur J Pediatr 2008;167:171-4.
10. Kotler DP. Cachexia. Ann Intern Med 2000;133:622-34.
11. Rosenbaum K, Wang J, Pierson RN Jr, Kotler DP. Time-dependent variation in weight and body composition in healthy adults. JPEN J Parenter Enteral Nutr 2000;24:52-5.
12. Jensen GL, Mirtallo J, Compher C, et al. Adult starvation and disease-related malnutrition: a proposal for etiology-based diagnosis in the clinical practice setting from the International Consensus Guideline Committee. JPEN J Parenter Enteral Nutr 2010;34:156-9.
13. MacKenzie JR, LaBan MM, Sackeyfio AH. The prevalence of peripheral neuropathy in patients with anorexia nervosa. Arch Phys Med Rehabil 1989;70:827-30. (Pubitemid 19271352)
14. Treasure J, Claudino AM, Zucker N. Eating disorders. Lancet 2010;375:583-93.
15. Mehler PS, Krantz M. Anorexia nervosa medical issues. J Womens Health (Larchmt) 2003;12:331-40. (Pubitemid 36701610)
16. Yager J, Andersen AE. Anorexia nervosa. N Engl J Med 2005;353:1481-8. (Pubitemid 41400922)
17. Hütter G, Ganepola S, Hofmann WK. The hematology of anorexia nervosa. Int J Eat Disord 2009;42:293-300.
18. Strumia R. Dermatologic signs in patients with eating disorders. Am J Clin Dermatol 2005;6:165-73. (Pubitemid 40994259)
19. Lo Russo L, Campisi G, Di Fede O, Di Liberto C, Panzarella V, Lo Muzio L. Oral manifestations of eating disorders: a critical review. Oral Dis 2008;14:479-84.
20. Støving RK, Hangaard J, Hansen-Nord M, Hagen C. A review of endocrine changes in anorexia nervosa. J Psychiatr Res 1999;33:139-52. (Pubitemid 29134742)
21. Ozawa Y, Shimizu T, Shishiba Y. Elevation of serum aminotransferase as a sign of multiorgan-disorders in severely emaciated anorexia nervosa. Intern Med 1998;37:32-9. (Pubitemid 128521455)
22. Rautou PE, Cazals-Hatem D, Moreau R, et al. Acute liver cell damage in patients with anorexia nervosa: a possible role of starvation-induced hepatocyte autophagy. Gastroenterology 2008;135:840-8.
23. Hudson JI, Hiripi E, Pope HG Jr, Kessler RC. The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biol Psychiatry 2007;61:348-58. (Pubitemid 46108682)
24. Overby KJ, Litt IF. Mediastinal emphysema in an adolescent with anorexia nervosa and self-induced emesis. Pediatrics 1988;81:134-6. (Pubitemid 18044304)
25. Diagnostic and statistical manual of mental disorders. 4th ed., text rev.: DSMIV-TR. Washington, DC: American Psychiatric Association, 2000.
26. Machado PP, Machado BC, Goncalves S, Hoek HW. The prevalence of eating disorders not otherwise specified. Int J Eat Disord 2007;40:212-7. (Pubitemid 46466601)
27. DSM-5 proposed diagnostic criteria for anorexia nervosa. Arlington, VA: American Psychiatric Association, 2010 (http://www.dsm5.org/ProposedRevisions/ Pages/proposedrevision.aspx?rid=24#).
28. Tajiri K, Shimizu Y, Tsuneyama K, Sugiyama T. A case report of oxidative stress in a patient with anorexia nervosa. Int J Eat Disord 2006;39:616-8. (Pubitemid 44621820)
29. Abarbanel JM, Berginer VM, Osimani A, Solomon H, Charuzi I. Neurologic complications after gastric restriction surgery for morbid obesity. Neurology 1987;37:196-200. (Pubitemid 17015490)
30. Denny-Brown D. Neurological conditions resulting from prolonged and severe dietary restriction; case reports in prisoners-of-war, and general review. Medicine 1947;26:41-113.
31. Elias WJ, Pouratian N, Oskouian RJ, Schirmer B, Burns T. Peroneal neuropathy following successful bariatric surgery: case report and review of the literature. J Neurosurg 2006;105:631-5. (Pubitemid 44525898)
32. Kumar N. Nutritional neuropathies. Neurol Clin 2007;25:209-55. (Pubitemid 46283309)
33. Lindboe CF, Askevold F, Slettebø M. Changes in skeletal muscles of young women with anorexia nervosa: an enzyme histochemical study. Acta Neuropathol 1982;56:299-302. (Pubitemid 12142670)
34. Attia E, Walsh BT. Behavioral management for anorexia nervosa. N Engl J Med 2009;360:500-6.