Abstract
BackgroundIndividuals who suffer from Anorexia Nervosa refuse to maintain a minimally normal body weight, are intensely afraid of gaining weight and exhibit a significant disturbance in the perception of the shape and size of their body. Postmenarchal females with this disorder are amenorrohic. In the Binge-Eating/Purging subtype individuals regularly engage in binge eating and purging behaviour (i.e self-induced vomiting or misuse of laxatives, diuretics, or enemas).Hypokalaemia is often seen in chronic Anorexia Nervosa, especially that of the purging type (ANp), and, as well as electrocardiographic anomalies, this can lead to tubulointerstitial nephritis (hypokalaemic nephropathy) with typical histological characteristics. The physiopathological mechanisms behind this damage are linked to altered stimulation of vasoactive mediators, and to the ammonium-mediated activation of the alternative complement pathway. However, it has not yet been ascertained whether a variant of the pathway specific for ANp [1], exists.Case presentationWe describe herein a case of hypokalaemic nephropathy in a patient affected by chronic ANp who presented to our Centre for Eating Disorders.ConclusionHypokalaemia can provoke cardiovascular alterations as well as muscular and renal complications, and thus potential renal damage needs to be investigated in patients suffering from long-term purgative anorexia.
Highlights
Individuals who suffer from Anorexia Nervosa refuse to maintain a minimally normal body weight, are intensely afraid of gaining weight and exhibit a significant disturbance in the perception of the shape and size of their body
Hypokalaemia is often seen in chronic Anorexia Nervosa, especially that of the purging type (ANp), and, as well as electrocardiographic anomalies, this can lead to tubulointerstitial nephritis with typical histological characteristics
Case presentation: We describe a case of hypokalaemic nephropathy in a patient affected by chronic ANp who presented to our Centre for Eating Disorders
Summary
Hypokalaemia can provoke cardiovascular alterations as well as muscular and renal complications, and potential renal damage needs to be investigated in patients suffering from long-term purgative anorexia. The patient, a 33-year-old female Caucasian nurse, was referred to our Centre for Eating Disorders by her GP She was affected by a severe untreated form of ANp with a duration of illness of 19 years. Three years prior to her arrival at the Centre, she had undergone a cone biopsy for adenocarcinoma in situ and had suffered a spontaneous abortion in the 3rd month of pregnancy She presented the main core eating disorder symptoms: she denied her underweight condition, she was obsessed with thoughts of food, weight and shape, she thought she couldn't stop bingeing and vomiting. She had decreased energy and difficulties in organizing her daily life. Oesophagogastroduodenoscopy (OGDS) showed grade "A" reflux oesophagitis (according to Los Angeles Classification [3]); abdominal ultrasound revealed bilateral reduction of the thickness of the renal cortex; renal scintigraphy exposed a bilateral delay in the arrival phase of the trace and no signs of obstructive uropathy were noted
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