Eating disorder - a diagnosis of exclusion
In adolescents with weight loss, diagnoses other than eating disorders should be considered, namely neurological diseases. A 16-year-old girl with an intellectual development disorder was referred to the Adolescent Medicine outpatient clinic from Child Psychiatry with a diagnosis of eating disorder and persistent anemia. Her body mass index was consistently below the fifth percentile and long-lasting eating difficulties were reported since the age of 15. The girl had no other gastrointestinal, articular, or respiratory complaints, neither polyuria, polydipsia, or recurrent fever. Parental divorce and domestic violence were reported. The patient complained of excessive daytime sleepiness, asthenia, intermittent myalgia, and muscular weakness episodes. Phenotypic characteristics and personal medical history led to clinical suspicion of a neuromuscular disease and genetic study confirmed myotonic dystrophy type 1. This case highlights the importance of considering other diagnoses besides eating disorders in adolescents with eating problems. An exhaustive evaluation of personal and family medical history, patient complaints, and detailed physical examination is mandatory.
Rome ES, Strandjord SE. Eating Disorders. Pediatric in Review. 2016; 37:323-336.
Meola G, Cardani R. Myotonic dystrophies: An update on clinical aspects, genetic, pathology, and molecular pathomechanisms. Biochim Biophys Acta. 2015; 1852:594–606.
Fiszer A, Krzyzosiak WJ. RNA toxicity in polyglutamine disorders: concepts, models, and progress of research. J Mol Med. 2013; 91:683–91.
Bouchard JP, Cossette L, Bassez G, Puymirat J. Natural history of skeletal muscle involvement in myotonic dystrophy type 1: a retrospective study in 204 cases. J Neurol. 2015; 262:285-93.
Engvall M, Sjögreen L, Kjellberg H, Robertson A, Sundell S, Kiliaridis S. Oral health status in a group of children and adolescents with myotonic dystrophy type 1 over a 4-year period. Int J Paediatr Dent. 2009; 19:412–22.
Umemoto G, Nakamura H, Oya Y, Kikuta T. Masticatory dysfunction in patients with myotonic dystrophy (type 1): a 5-year follow-up. Spec Care Dentist. 2009; 29:210–4.
Lau JK, Sy RW, Corbett A, Kritharides L. Myotonic dystrophy and the heart: A systematic review of evaluation and management. Int J Cardiol. 2015; 184:600–8.
Turner C, Hilton-Jones D. Myotonic dystrophy: diagnosis, management and new therapies. Curr Opin Neurol. 2014; 27:599.
Hicks CW, DeMarsh S, Singh H, Gillespie LA, Worley S, Rome ES, et al. Knowledge about various contraceptive methods in young women with and without eating disorders. Int J Eat Disord. 2013; 46:171-6.
Bergström I, Crisby M, Engström AM, Hölcke M, Fored M, Kruse PJ, et al. Women with anorexia nervosa should not be treated with estrogen or birth control pills in a bone-sparing effect. Acta Obstet Gynecol Scand. 2013; 92:877-80.
Copyright (c) 2020 NASCER E CRESCER - BIRTH AND GROWTH MEDICAL JOURNAL
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright and access
This journal offers immediate free access to its content, following the principle that providing free scientific knowledge to the public provides greater global democratization of knowledge.
The works are licensed under a Creative Commons Attribution Non-commercial 4.0 International license.
Nascer e Crescer – Birth and Growth Medical Journal do not charge any submission or processing fee to the articles submitted.