RESUMEN
Awareness of the signs and symptoms of eating disorders is essential for primary care physicians who work with children, adolescents, and young adults. In this article, Drs Kondo and Sokol describe the clinical manifestations of eating disorders such as anorexia nervosa, bulimia nervosa, and binge-eating disorder, which usually occur in adolescence and early adulthood, and pica and rumination disorder, which are more characteristic of infancy and early childhood. The authors also discuss risk factors for and medical complications of eating disorders and present current treatment methods.
Asunto(s)
Trastornos de Alimentación y de la Ingestión de Alimentos/diagnóstico , Trastornos de Alimentación y de la Ingestión de Alimentos/terapia , Atención Primaria de Salud , Antidepresivos/uso terapéutico , Terapia Cognitivo-Conductual , Trastornos de Alimentación y de la Ingestión de Alimentos/complicaciones , Humanos , Factores de RiesgoRESUMEN
A 14-year-old girl with anorexia nervosa (AN) was found to have an intracranial neoplasm. Atypical psychological symptoms prompted further evaluation, including electroencephalogram and neuroimaging, which revealed a sellar and suprasellar mass. This patient had an eating disorder and a brain tumor, which appear to be two unrelated conditions. However, it remains unclear how each affected the other. The diagnosis of AN, like all other psychiatric disorders, requires that possible medical etiologies and coexisting medical problems be excluded. AN and other eating disorders are particularly difficult to diagnose in children and adolescents because they often do not present in the manner typical of adults. Perceptual and cognitive disturbances associated with AN are difficult to evaluate because children and adolescents normally change over time as they progress through different stages of development. Therefore, it is particularly important to evaluate for the presence of medical conditions when a diagnosis of an eating disorder is made in a child or adolescent.
Asunto(s)
Anorexia Nerviosa/complicaciones , Neoplasias Encefálicas/complicaciones , Adolescente , Neoplasias Encefálicas/patología , Neoplasias Encefálicas/cirugía , Depresión/diagnóstico , Depresión/tratamiento farmacológico , Depresión/etiología , Femenino , Fluoxetina/uso terapéutico , Humanos , Imagen por Resonancia Magnética , Inhibidores Selectivos de la Recaptación de Serotonina/uso terapéuticoRESUMEN
OBJECTIVE: The authors' goal was to determine whether D8/17, a rheumatic fever susceptibility trait marker, identifies a possible type of anorexia nervosa: pediatric autoimmune neuropsychiatric disorders associated with streptococcus (PANDAS) anorexia nervosa. METHOD: Using immunofluorescence, the authors measured the percentage of D8/17-positive B lymphocytes in the peripheral blood of 16 subjects 7-21 years old who had not had rheumatic fever but who had possible PANDAS anorexia nervosa. The comparison subjects were 17 psychiatric patients with no eating disorder and no PANDAS characteristics. Subjects were considered D8/17 positive if they had 12% or more D8/17+ cells. RESULTS: There were more D8/17-positive individuals among those with PANDAS anorexia nervosa (81%) than among the comparison subjects (12%). The subjects with PANDAS anorexia nervosa had a higher percentage of D8/17+ cells (mean=27.1%, SD=17%) than the comparison subjects (mean=5.3%, SD=7.4%). CONCLUSIONS: A larger study is needed to determine whether D8/17 serves as a marker for susceptibility to a type of anorexia nervosa.