Abstract
Purpose
Avoidant restrictive food intake disorder (ARFID) was recently characterized, according to the DSM-5 classification, as a feeding and eating disorder (FED). However, ARFID remains poorly known by most pediatricians, but also by psychiatrists and primary care professionals. Despite the fact that patients with ARFID generally have a higher BMI than patients with anorexia nervosa, our purpose was to highlight the fact that they may present severe nutritional deficiencies and major somatic complications when the diagnosis is delayed.
Method
We describe here a case of a 16-year-old boy who presented with severe undernutrition (BMI = 11.5) leading to Ogilvie’s syndrome, which resolved with enteral refeeding. Because of undernutrition, very bad dental condition, and encopresis, some physicians wrongly suspected child neglect, but retrospective analysis of his personal history revealed a long-term FED and sensory specificities that led to the final diagnosis of an ARFID–autism spectrum disorder (ASD) association. A literature review was conducted on the ARFID somatic complications.
Conclusion
The training of health professionals in the clinical forms of pediatric FED, including ARFID, is necessary, to promote early diagnosis and prevent poor nutritional outcomes. In this case the association of ARFID–ASD and the delay in access to specialized care favored by the disadvantaged social environment led to severe gastrointestinal complications.
Level of evidence
V, descriptive study.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn text revised. (DSM V). Washington, DC
Magel CA, Hewitt K, Dimitropoulos G, von Ranson KM, McMorris CA (2021) Who is treating ARFID, and how? The need for training for community clinicians. Eat Weight Disord 26:1279–1280. https://doi.org/10.1007/s40519-020-01007-1
Oliveira SB (2021) Why is avoidant-restrictive food intake disorder relevant to the pediatric gastroenterologist? JAMA Pediatr 175:455–457. https://doi.org/10.1001/jamapediatrics.2020.5784
Zimmerman J, Fisher M (2017) Avoidant/Restrictive Food Intake Disorder (ARFID). Curr Probl Pediatr Adolesc Health Care 47:95–103. https://doi.org/10.1016/j.cppeds.2017.02.005
Lucarelli J, Pappas D, Welchons L, Augustyn M (2017) Autism spectrum disorder and avoidant/restrictive food intake disorder. J Dev Behav Pediatr 38:79–80. https://doi.org/10.1097/DBP.0000000000000362
Sharp WG, Berry RC, McCracken C, Nuhu NN, Marvel E, Saulnier CA, Klin A, Jones W, Jaquess DL (2013) Feeding problems and nutrient intake in children with autism spectrum disorders: a meta-analysis and comprehensive review of the literature. J Autism Dev Disord 43:2159–2173. https://doi.org/10.1007/s10803-013-1771-5
Leader G, Hogan A, Chen JL, Maher L, Naughton K, O’Rourke N, Casburn M, Mannion A (2021) Age of autism spectrum disorder diagnosis and comorbidity in children and adolescents with autism spectrum disorder. Dev Neurorehabil 1:1–9. https://doi.org/10.1080/17518423.2021.1917717
Eddy KT, Thomas JJ, Hastings E, Edkins K, Lamont E, Nevins CM, Patterson RM, Murray HB, Bryant-Waugh R, Becker AE (2015) Prevalence of DSM-5 avoidant/restrictive food intake disorder in a pediatric gastroenterology healthcare network. Int J Eat Disord 48:464–470. https://doi.org/10.1002/eat.22350
Feillet F, Bocquet A, Briend A, Chouraqui JP, Darmaun D, Frelut ML, Girardet JP, Guimber D, Hankard R, Lapillonne A, Peretti N, Rozé JC, Simeoni U, Turck D, Dupont C, Comité de nutrition de la Société française de pédiatrie (CNSFP) (2019) Nutritional risks of ARFID (avoidant restrictive food intake disorders) and related behavior. Arch Pediatr 26:437–441. https://doi.org/10.1016/j.arcped.2019.08.005
Wells CI, O’Grady G, Bissett IP (2017) Acute colonic pseudo-obstruction: a systematic review of aetiology and mechanisms. World J Gastroenterol 23:5634–5644. https://doi.org/10.3748/wjg.v23.i30.5634
Benezech S, Hartmann C, Morfin D, Bertrand Y, Domenech C (2020) Is it leukemia, doctor? No, it’s scurvy induced by an ARFID! Eur J Clin Nutr 74:1247–1249. https://doi.org/10.1038/s41430-020-0640-5
Chandran JJ, Anderson G, Kennedy A, Kohn M, Clarke S (2015) Subacute combined degeneration of the spinal cord in an adolescent male with avoidant/restrictive food intake disorder: A clinical case report. Int J Eat Disord 48:1176–1179. https://doi.org/10.1002/eat.22450
Yule S, Wanik J, Holm EM, Bruder MB, Shanley E, Sherman CQ, Fitterman M, Lerner J, Marcello M, Parenchuck N, Roman-White C, Ziff M (2021) Nutritional deficiency disease secondary to ARFID symptoms associated with autism and the broad autism phenotype: a qualitative systematic review of case reports and case series. J Acad Nutr Diet 121:467–492. https://doi.org/10.1016/j.jand.2020.10.017
Eddy KT, Harshman SG, Becker KR, Bern E, Bryant-Waugh R, Hilbert A, Katzman DK, Lawson EA, Manzo LD, Menzel J, Micali N, Ornstein R, Sally S, Serinsky SP, Sharp W, Stubbs K, Walsh BT, Zickgraf H, Zucker N, Thomas JJ (2019) Radcliffe ARFID Workgroup: toward operationalization of research diagnostic criteria and directions for the field. Int J Eat Disord 52:361–366. https://doi.org/10.1002/eat.23042
Acknowledgements
The authors are grateful to Nikki Sabourin-Gibbs, Rouen University Hospital, for her help in editing the manuscript.
Funding
This work was done with no specific support.
Author information
Authors and Affiliations
Contributions
VB conceptualized and designed the case report, collected and analyzed data, drafted the initial manuscript, and revised the manuscript. CD analyzed data, and critically reviewed and revised the manuscript. PD analyzed data, and critically reviewed and revised the manuscript for important intellectual content. MF analyzed data, and critically reviewed and revised the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
Corresponding author
Ethics declarations
Conflict of interest
The authors have no conflict of interest to declare.
Ethical approval
The authors have checked that they complied with the specific and ethical requirements of their institution.
Informed consent
Informed consent of parents was obtained to publish the minor patient’s data.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Bertrand, V., Dhenin, C., Déchelotte, P. et al. Delayed avoidant restrictive food intake disorder diagnosis leading to Ogilvie’s syndrome in an adolescent. Eat Weight Disord 27, 1913–1918 (2022). https://doi.org/10.1007/s40519-021-01315-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40519-021-01315-0