Unrecognized and Untreated: Refeeding Syndrome Complicating Treatment of Schizophrenia

This case report was considered to present refeeding syndrome and the occurrence of schizophrenia could be due to eating disorder. It is about a 40-year-old female patient, former employee at a local bank, ex-principal at a local school, and an NGO worker with a past psychiatric history of psychotic episodes previously treated with multiple antipsychotics along with suspected non-compliance. The patient had not been eating for several weeks, and her father described her as severely malnourished. She exhibited severe paranoid delusions, including a fear that people were trying to harm her. She would particularly refuse any male who tried to approach her. She was suffering from fatigue, muscle weakness, confusion, and fluid retention. Her bloodwork revealed low serum electrolytes and slightly elevated liver function tests. Careful electrolyte repletion and slow reintroduction of nutrition were adopted to treat this patient. Chronic illnesses like schizophrenia could be a risk for eating disorders. Phenomenon like refeeding syndrome could be seen and should be diagnosed.