Echocardiographic investigation of pericardial effusion in a case of anorexia nervosa

Abstract

Pericardial effusion has recently been reported as a complication of anorexia nervosa. A distinct pathophysiological cause of it could not be revealed. In some reports, there was a probable correlation between weight gain and reduction of pericardial effusion in anorexia nervosa cases. We encountered a case in which pericardial effusion remitted completely along with body weight increase and normalization of low T3 syndrome. These findings suggest that the reduction of pericardial effusion may correlate with both weight gain and low T3 normalization. Plasma brain natriuretic peptide (BNP) levels were increased in this case despite heart failure, and plasma BNP decreased as pericardial effusion remitted. The measurement of serum BNP level may be a clinical parameter in such a case of pericardial effusion.

Cardiovascular complications of anorexia nervosa: A systematic review

“…One study observed that pericardial effusion remitted with weight gain and normalization of serum T3 levels. 2 This was corroborated by a more recent study of 173 adolescent patients with AN. 3 They found that 35% of patients had a pericardial effusion; in contrast no control patients had evidence of pericardial effusion.…”

“…The etiology of pericardial effusion in AN is uncertain. One study observed that pericardial effusion remitted with weight gain and normalization of serum T3 levels . This was corroborated by a more recent study of 173 adolescent patients with AN .…”

Pericardial effusion requiring pericardiocentesis in a girl with anorexia nervosa

“…Inagaki et al 8 found increased plasma levels of BNP in a patient with anorexia nervosa and pericardial effusion. Plasma BNP decreased as pericardial effusion remitted.…”

“…In clinical practice, patients with similar or even lower BMI are currently seen without cardiac involvement. An association of low T 3 syndrome and pericardial effusion has been hypothesized, 8 with both changes disappearing completely after body weight increase; thus, low T 3 syndrome and pericardial effusion could be independently related to the anorectic condition. Other common causes of pericardial effusion, such as acute pericarditis of infectious origin, can also be excluded in this patient.…”

Elevated Myocardial Enzymes and Natriuretic Peptides in Anorexia Nervosa: Prototypic Condition for the Pathophysiology of Cachexia?

“…Atrial fibrillation was not detected. Pericardial effusion and elevated NT-proBNP levels have been suspected to be linked in AN [18]. Still, in our case, pericardial effusion was ruled out by both echocardiography and cardiac MRI.…”