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Severe anorexia nervosa associated with osteoporotic‐linked femural neck fracture and pulmonary tuberculosis: A case report
Author(s) -
Rose Matthias,
Hildebrandt Martin,
Schoeneich Frank,
Danzer Gerhard,
Klapp Burghard F.
Publication year - 1999
Publication title -
international journal of eating disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.785
H-Index - 138
eISSN - 1098-108X
pISSN - 0276-3478
DOI - 10.1002/(sici)1098-108x(199905)25:4<463::aid-eat12>3.0.co;2-q
Subject(s) - anorexia nervosa , medicine , convalescence , malnutrition , anorexia , osteoporosis , pediatrics , weight gain , tuberculosis , cachexia , femoral neck , weight loss , body mass index , surgery , eating disorders , body weight , psychiatry , obesity , cancer , pathology
We report a case study of a 38‐year‐old woman who had been suffering from anorexia nervosa (AN) since the age of 26. Before admittance to our clinic, she weighed 23.8 kg (at a height of 164 cm, 8.8 body mass index [BMI]) but still carried out strenuous physical activities. After good psychotherapeutic response and weight gain (34.4 kg), she accidentally fell and broke her femoral neck—favored as it was by osteoporosis. The X‐ray taken before dynamic hip screw implantation coincidentally showed signs of pulmonary tuberculosis (TB), which could then be proven by computed tomography (CT) scans and cultures from a bronchoscopy. Other than lack of appetite and loss of weight, which we attributed to AN, there were no other clinical or biochemical indicators which could have pointed to an earlier TB diagnosis. As a result, the need for screening procedures is discussed. The manifestation of TB during the first weight gain after 12 years of severe malnutrition, during which there were no serious infections, seems to endorse former observations that AN patients appear to be “resistant” to some extent against infectious diseases, a “protection” which may be lost with convalescence and weight gain. © 1999 by John Wiley & Sons, Inc. Int J Eat Disord 25: 463–467, 1999.