1/10. hypophosphatemia secondary to oral refeeding in anorexia nervosa.OBJECTIVE: hypophosphatemia is a well-known complication of the refeeding syndrome in severe cases of anorexia nervosa, described mostly as a result of refeeding with total parenteral nutrition. Few cases have been reported secondary to either nasogastric or oral refeeding. METHOD: The authors present three cases in which hypophosphatemia developed secondary to oral refeeding in severe anorexia nervosa. RESULTS: All 3 patients developed significant hypophosphatemia, to a low of 0.9 mg/dl in two cases and a low of 1. 7 mg/dl in the third. The first patient received close to 3,000 calories per day, along with intravenous fluids, in the hospital; the other 2 patients ate large amounts for several days at home. caloric restriction and replenishment with phosphorous resulted in a rapid return of phosphorous values to normal levels. DISCUSSION: Those who treat severely malnourished patients with eating disorders, whether as inpatients or outpatients, need to be vigilant for the development of the refeeding syndrome, even in patients receiving oral refeeding alone.- - - - - - - - - - ranking = 1keywords = anorexia nervosa, nervosa, anorexia (Clic here for more details about this article) |
2/10. life-threatening refeeding syndrome in a severely malnourished anorexia nervosa patient.Overzealous refeeding in chronically malnourished anorexia nervosa patients may cause life-threatening complications. We describe a 14-year-old girl with anorexia nervosa who had a decrease in body weight from 45 kg to 25.5 kg over an 18-month period. She received 40 kcal.kg-1.d-1 carbohydrate-rich nutrition via enteral and parenteral routes. Her serum phosphate concentration dropped from a baseline of 1.39 mmol/L (4.3 mg/dL) to 0.19 mmol/L (0.6 mg/dL) on Day 4 of refeeding. Concurrent with the development of hypophosphatemia, she became drowsy and developed generalized muscle weakness, impaired myocardial contractility, thrombocytopenia, and gastrointestinal bleeding. Fluid overload with pulmonary edema complicated her recovery from these adverse events. After intravenous phosphate supplementation and fluid restriction, the symptoms of refeeding syndrome gradually resolved within 2 weeks. In chronically malnourished anorexia nervosa patients, nutritional support should be instituted gradually to avoid rapid electrolyte shifts and fluid overload. serum phosphate concentrations, fluid status, and blood cell counts should be closely monitored.- - - - - - - - - - ranking = 1.037886451759keywords = anorexia nervosa, nervosa, anorexia (Clic here for more details about this article) |
3/10. Reversible tubular dysfunction that mimicked Fanconi's syndrome in a patient with anorexia nervosa.Patients with anorexia nervosa exhibit acid-base and electrolyte disturbances. hypophosphatemia is commonly found in these patients during nutritional recovery. However, marked, possibly, life-threatening hypophosphatemia associated with proximal tubular dysfunction has not been previously described. We report a case of anorexia nervosa complicated by a nonacidotic proximal tubulopathy, which was manifested by renal glycosuria, as well as inappropriate phosphaturia and uricosuria resulting in hypophosphatemia and hypouricemia.- - - - - - - - - - ranking = 1keywords = anorexia nervosa, nervosa, anorexia (Clic here for more details about this article) |
4/10. Haemolytic anaemia in a patient with anorexia nervosa.We report on a 17-year-old female patient with severe anorexia nervosa (AN) (body mass index of 9.8 kg/m(2)) who developed hypophosphataemia (serum phosphate 0.4 nmol/l) and subsequent haemolytic anaemia during oral refeeding. Hypophosphataemia due to an increased phosphate uptake may lead to a reduction of erythrocyte adenosine triphosphate. This mechanism is important for the differential diagnosis of haemolytic anaemia in patients with AN. To prevent this complication, phosphate supplementation should be considered in the refeeding of severely malnourished patients.- - - - - - - - - - ranking = 0.83333333333333keywords = anorexia nervosa, nervosa, anorexia (Clic here for more details about this article) |
5/10. hypophosphatemia following self-treatment for anorexia nervosa.hypophosphatemia is recognized as a serious complication of hospital treatment for patients with anorexia nervosa but may also occur prior to medical intervention. METHOD: This paper reports a case of severe hypophosphatemia in a patient who consumed large quantities of carbohydrates following a period of dietary restraint. DISCUSSION: The possible mechanisms underlying the hypophosphatemia in this case are discussed and its management is described.- - - - - - - - - - ranking = 0.83333333333333keywords = anorexia nervosa, nervosa, anorexia (Clic here for more details about this article) |
6/10. Severe hypophosphatemia in a patient with anorexia nervosa during enteral refeeding.hypophosphatemia is a seldom but potentially fatal complication of the nutritional recovery or refeeding syndrome in patients with protein-calorie malnutrition or starvation. We report here the case of a 35-year-old anorexic patient who presented a severe but uncomplicated hypophosphatemia during enteral refeeding, despite phosphorus supplementation. serum phosphorus monitoring is recommended in severely malnourished anorexic patients, particularly during the first week of refeeding, be it parenteral or enteral.- - - - - - - - - - ranking = 0.66666666666667keywords = anorexia nervosa, nervosa, anorexia (Clic here for more details about this article) |
7/10. Severe hypophosphataemia during stem cell harvesting in chronic myeloid leukaemia.Peripheral blood stem cell autografts for the treatment of chronic myeloid leukaemia (CML) are currently under evaluation. A patient with CML received intensive chemotherapy followed by granulocyte colony-stimulating factor prior to the collection of peripheral blood derived stem cells. He developed unusually severe, and fatal, hypophosphataemia and this coincided with the rapid rise of his peripheral blood white cell count. The hypophosphataemia was considered to be due to a combination of severe anorexia, sepsis and the rapid growth factor-stimulated myeloid regeneration in CML.- - - - - - - - - - ranking = 0.016998309144281keywords = anorexia (Clic here for more details about this article) |
8/10. Severe hypophosphataemia in anorexia nervosa.In addition to well-described acid-base and electrolyte disturbances, anorexia nervosa may be complicated by severe hypophosphataemia. We report a case of anorexia nervosa complicated by life-threatening hypophosphataemia manifesting as generalized muscle weakness and bulbar muscle dysfunction, resulting in an aspiration pneumonia and cardiorespiratory arrest.- - - - - - - - - - ranking = 1keywords = anorexia nervosa, nervosa, anorexia (Clic here for more details about this article) |
9/10. anorexia nervosa: refeeding and hypophosphatemia.A case of anorexia nervosa (AN) is reported where heart failure occurred secondary to severe hypophosphatemia despite oral phosphate supplementation. We recommend starting patients with AN on oral phosphate when refeeding is begun, monitoring serum phosphate every 1 to 2 days for at least the first week of refeeding, and discontinuation of refeeding during phosphate supplementation should severe hypophosphatemia develop.- - - - - - - - - - ranking = 0.25021923712551keywords = anorexia nervosa, nervosa, anorexia (Clic here for more details about this article) |
10/10. hypophosphatemia in malnourished children during refeeding.hypophosphatemia in malnourished children during nutritional recovery (refeeding hypophosphatemia) is recognized as a cause of morbidity and mortality in adolescents with anorexia nervosa but has been only rarely reported to occur in younger children with other diagnoses. Over a 6-year period, we encountered three cases of refeeding hypophosphatemia in malnourished children admitted to a pediatric rehabilitation hospital. Two children had neurologic dysphagia and one had been starved by an abusive parent. The one patient who was symptomatic had obtundation, hemolytic anemia, rhabdomyolysis, and hepatocellular injury that began during refeeding and resolved with treatment. The signs and symptoms, pathophysiology, and treatment of refeeding hypophosphatemia are reviewed.- - - - - - - - - - ranking = 0.16666666666667keywords = anorexia nervosa, nervosa, anorexia (Clic here for more details about this article) |
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