Central diabetes insipidus associated with refeeding in anorexia nervosa: A case report

Rosen, Elaine; Thambundit, Apisadaporn; Mehler, Philip S.; Mittelman, Steven D.

doi:10.1002/eat.23087

Cited by 7 publications

(9 citation statements)

References 17 publications

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“…Critical hyponatremia can emerge because patients with AN also tend towards hyponatremia due to reduced solute load being delivered to the distal renal tubules and inability to clear free water. Abnormally low ADH secretion has also been described and results in diabetes insipidus with concomitant hypernatremia [68].…”

Section: The Endocrinological and Metabolic Setting Of Anmentioning

confidence: 99%

Reframing anorexia nervosa as a metabo-psychiatric disorder

Bulik

Carroll

Mehler

2021

Trends in Endocrinology & Metabolism

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Anorexia nervosa (AN) is a serious and often fatal illness. Despite decades of research, investigators have failed to adequately advance our understanding of the biological aspects of AN that could inform the development of effective interventions. Genome-wide association studies are revealing the important role of metabolic factors in AN, and studies of the gastrointestinal tract are shedding light on disruptions in enteric microbial communities and anomalies in gut morphology. In this opinion piece, we review the state of the science through the lens of the clinical presentation of illness. We project how the integration of rigorous science in genomics and microbiology, in collaboration with experienced clinicians, has the potential to markedly enhance treatment outcome via precision interventions. Shifting paradigms in understanding and treating ANAN rests squarely on the psyche-soma border; however, etiological theories and treatments have historically focused on psychological, family, and societal factors. A conceptual shift is underway. The latest genome-wide association study (GWAS; see Glossary) for AN [1] suggested reconceptualizing AN as a 'metabo-psychiatric disorder'. In addition to identifying eight significantly associated genomic loci, a rich panel of genetic correlations underscored the role of psychiatric, anthropometric, and metabolic factors in the etiology of this highly lethal disease.

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Section: The Endocrinological and Metabolic Setting Of Anmentioning

confidence: 99%

Reframing anorexia nervosa as a metabo-psychiatric disorder

Bulik

Carroll

Mehler

2021

Trends in Endocrinology & Metabolism

View full text Add to dashboard Cite

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“…Review of the literature revealed case reports of abnormal arginine vasopressin (AVP) axis function in patients with anorexia nervosa (AN). It is hypothesized that refeeding patients with severe malnutrition secondary to AN led to the development of DI [ 9 ]. These patients' AVP axes recovered over time, usually over the course of two weeks to several months [ 9 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…It is hypothesized that refeeding patients with severe malnutrition secondary to AN led to the development of DI [ 9 ]. These patients' AVP axes recovered over time, usually over the course of two weeks to several months [ 9 , 10 ]. Several studies have shown alterations of osmoregulation in patients with AN, which is thought to be associated with severity of and duration of AN [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Severe Hypernatremia in a Significantly Underweight Female Child

Coriell

Gandham

Wintergerst

et al. 2021

Case Reports in Pediatrics

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In this study, we present the case of a 5-year-old female who presented for evaluation of dehydration with labs that revealed significant hypernatremia concerning for diabetes insipidus (DI). Further evaluation revealed that she had underlying chronic malnutrition. Her diagnostic work up for DI produced some evidence consistent with DI while other data indicated otherwise, bringing up the possibility of partial DI. She was ultimately diagnosed with sporadic vasopressin release secondary to her chronic malnutrition. This case illustrates another effect chronic malnutrition can have on pediatric patients along with the importance of a broad differential for patients with severe hypernatremia.

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“…The endocrine system is greatly disrupted by AN [ 66 ]. Aside from amenorrhea which is commonly found (88%), other complication such as diabetes insipidus, are relatively rare [ 67 ]. The most serious endocrine complication, found in about 10% of both types of AN [ 40 ], is hypoglycemia [ 67 ].…”

Section: Medical Complicationsmentioning

confidence: 99%

Emergency room presentations of people with anorexia nervosa

et al. 2023

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People with anorexia nervosa (AN) tend to shy away from engaging in typical primary care provider relationships in order to avoid detection. Therefore, they may seek care for their medical concerns through a local emergency department (ED). Inherently, AN is associated with a litany of medical complications, which become more prevalent as the severity of their eating disorder increases. Notwithstanding the typical young age at the onset of AN, no body system is immune to these medical complications. Thus, ED providers may need to pursue a medical diagnosis in order to explain presenting symptoms in people with AN. In addition to the medical issues, AN is also a serious mental illness with high mortality rates, including deaths by suicide. Therefore, ED providers also need to be familiar with relevant mental health issues for these people.

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Central diabetes insipidus associated with refeeding in anorexia nervosa: A case report

Cited by 7 publications

References 17 publications

Reframing anorexia nervosa as a metabo-psychiatric disorder

Reframing anorexia nervosa as a metabo-psychiatric disorder

Severe Hypernatremia in a Significantly Underweight Female Child

Emergency room presentations of people with anorexia nervosa

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