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A loss of consciousness in a teenage girl with anorexia nervosa, due to polydipsia: case report and a minireview

  • Aneta KrogulskaEmail author
  • Dominika Nowicka
  • Zbigniew Nowicki
  • Monika Parzęcka
  • Agnieszka Sakson-Słomińska
  • Renata Kuczyńska
Case Report

Abstract

Purpose

Anorexia nervosa is a chronic disease which may result in various complications. In pediatric clinical practice, it is common to observe complications related to progressive cachexia caused by malnutrition; however, cases of severe complications, like electrolyte disorders, which represent a direct threat to life, due to polydipsia, are rarely observed. The purpose of this study is to highlight that excessive drinking is of primary importance in anorexia nervosa patients, as it can result in severe medical complications, including increased risk of death.

Methods

We report the case of a 13-year-old girl with anorexia nervosa, who was referred to hospital with seizures, disorders of consciousness, and cardiorespiratory failure.

Results

The unstable condition of the patient was attributed to hyponatremia (119 mmol/l), decreased serum osmolality (248 mmol/kg), and decreased urine osmolality (95 mmol/kg) caused by polydipsia (water intoxication) and persistent vomiting. The presented girl was drinking large amounts of water prior to a weigh-in to falsify her low body weight.

Conclusions

Polydipsia is a common problem reported by patients with eating disorders, but one which rarely leads to serious clinical complications, due to severe hyponatremia. This case underscores the importance of careful evaluation of fluid intake and the need for regular monitoring of serum electrolytes in patients with anorexia nervosa. All clinicians treating patients with such disease, as well as the parents of sick children, should be familiar with this life-threatening condition.

Level IV

Evidence obtained from multiple time series with or without the intervention, such as case studies.

Keywords

Anorexia nervosa Complications Malnutrition Polydipsia Hyponatremia Water intoxication 

Notes

Funding

This manuscript received any funding.

Compliance with ethical standards

Conflict of interest

AK, DN, ZN, MP, ASS, and RK declare that have no significant financial and non-financial conflict of interest that might have influenced the performance or presentation of the work described in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from the mother of the child for publication of this case report.

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Copyright information

© The Author(s) 2019

Authors and Affiliations

  • Aneta Krogulska
    • 1
    Email author
  • Dominika Nowicka
    • 2
  • Zbigniew Nowicki
    • 2
  • Monika Parzęcka
    • 3
  • Agnieszka Sakson-Słomińska
    • 1
  • Renata Kuczyńska
    • 1
  1. 1.Department of Pediatrics, Allergology and Gastroenterology, Collegium Medicum BydgoszczNicolaus Copernicus University of ToruńBydgoszczPoland
  2. 2.Student gastroenterological research group, Department of Pediatrics, Allergology and Gastroenterology, Collegium Medicum BydgoszczNicolaus Copernicus University of ToruńBydgoszczPoland
  3. 3.Department of Pediatric Endoscopy and Gastrointestinal Function Testing, Collegium Medicum BydgoszczNicolaus Copernicus University of ToruńBydgoszczPoland

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