Anorexic Girl Presenting with Severe Bradycardia and Amenorrhea: A Serious Presentation of a Medical Condition
AbstractAnorexia Nervosa is an eating disorder presenting with a low weight in patients with a fear of gaining weight leading to restriction of intake. Patients with this disorder have a strong desire to stay thin, with the psychological stress and nutritional deficiency in such patient the symptoms can vary with patient often being difficult to diagnose.
Case Presentation A 22 year old lady presented in the tertiary care hospital, Karachi, Pakistan with complain of amenorrhea. According to the patient her menstrual cycle had been completely normal until four months back when it suddenly stopped. The patient's attendant reported a history of weight loss in the patient with a gradual and progressive weight loss of 25 kg in the past 6 months with normal appetite but doing excessive exercise. Previously the patient had been admitted due to acute gastroenteritis which resolved in 2 days. Investigations were carried out, the patient had a BMI of 14.3 kgm-2 and a heartrate of 40 beats/min. MRI showed no signs of micro or macro adenoma of the pituitary. Her FSH, LH and free T4 were reduced and she was found to be hypotensive with a blood pressure of 90/60 mmHg.
Treatment Course She was initially kept in ward to monitor her blood pressures with fluid being given. After an interview with the patient and her family a diagnoses of anorexia nervosa was reached with the patient being started on SSRI treatment. Thyroxine was also given to bring FT4 to normal range.
Keywords:Anorexia Nervosa, Pakistan
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