Anorexia nervosa and systemic lupus erythematosus: a coincidence?

Abstract

Introduction and importance: The COVID-19 pandemic has led to a post-acute syndrome that can persist for an extended period. The correlation between anorexia nervosa (AN) and some autoimmune diseases has been reported. Systemic lupus erythematosus (SLE) is a systemic autoimmune disease, presented with different clinical ions and periods, affecting all ages, especially females. The coexistence of SLE and AN has been reported in rare cases. The authors present the case of a 22-year-old male with severe AN coexisting with SLE. Case presentation: We present a case of a 22-year-old male diagnosed with SLE. He also completely refused to eat and drink and presented with behavioral disorders and suicidal thoughts. He was on 200 mg/day of oral hydroxychloroquine, 400 units/day of vitamin D, and 1000 mg/day of oral calcium. There was no positive other history, trauma, drug addiction, or family history. AN was diagnosed according to ICD-10 and DSM-V. Physical examination revealed decreased subcutaneous tissue and muscle atrophy. The weight of the patient was 35.3 kg. Verbal contact was maintained, and psychotic symptoms were not observed. Tenderness in all joints was noticed, while swelling in both knees and right ankle joints was found. Laboratory tests revealed elevated inflammatory markers. Treatment includes a high-calorie diet administered by a feeding tube. The patient began to gain weight after 3 months. He is on 200 mg/day hydroxychloroquine, with remission till now January 2024. Clinical discussion: The novelty of our case is that it is a case of a young adult man presented with AN during mild lupus, who responded well to treatment with steroids and a high-calorie diet. Conclusions: Previous research has suggested the existence of a close link between food and eating disturbance and autoimmunity, and herein we provide further evidence to support this relationship by presenting a case report of an adult male with SLE and AN.