Case Report

Anorexic Girl Presenting with Severe Bradycardia and Amenorrhea: A Serious Presentation of a Medical Condition

Sajjad Ali Khan1
Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
Asma Ahmed1
Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
Zafar Aleem Suchal2
Aga Khan Medical College, Aga Khan University Hospital, Karachi, Pakistan
Ainan Arshad1
Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan

✉ Correspondence: Ainan Arshad Email: ainan_arshad@hotmail.com

DOI https://doi.org/10.70302/jpsim.v2i2.2137
Volume: 2, Issue 2 Pages: 151–153 Published: 17 Jun 2021
Received: 20 Feb 2021 Accepted: 17 Apr 2021 Published Online: 17 Jun 2021

Abstract

Anorexia 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

How to Cite This Article

Khan SA, Ahmed A, Suchal ZA, Arshad A. Anorexic Girl Presenting with Severe Bradycardia and Amenorrhea: A Serious Presentation of a Medical Condition. J Pak Soc Intern Med. 2021;2(2):151–153. doi:10.70302/jpsim.v2i2.2137

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Conflict of Interest

All authors declare no competing interests.

Disclosed in accordance with ICMJE and COPE guidelines.

Funding

No specific funding was received for this research.

Funder information follows the Crossref Funder Registry standard.

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Reference list indexed for Google Scholar and ResearchGate. DOI links resolve via doi.org.

CC BY CC BY 4.0 This article is published under the Creative Commons Attribution 4.0 International License. May be shared and adapted with attribution. © 2021 Journal of Pakistan Society of Internal Medicine.
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