SEVERE COMPLICATIONS OF EATING DISORDERS IN ADOLESCENTS - 99 HOSPITALIZED-PATIENTS

Background. Subclinical medical complications frequently occur during the follow-up of anorexia nervosa and bulimia. This paper describes so me of these. Population and methods. Charts of 99 adolescent patients (89 girls and 10 boys), aged 11.8 to 22 years (mean: 16.6 +/- 2.1 year s), admitted for anorexia nervosa (N: 92) or bulimia (N: 7), were anal yzed retrospectively. All severe or potentially severe, clincal and no n-clinical, findings at admission were included in the study. Results. Anorexic patients had a mean weight loss of 31.5% (22 of them were al so vomiters or laxative abusers). Initial nasogastric tube feeding was necessary in 19 patients and parenteral nutrition in 2. Bradycardia a nd hypotension were common. A variety of ECG abnormalities were seen i n 86% of the patients. Mitral valve prolapse was present in 14 of the 43 patients examined by echocardiography. Electrolyte imbalance was al so common: hyponatremia in 7 patients, hypokalemia in 21, hypochloremi a in 10 of the 12 vomiters, hypophosphatemia in 7, hyperazotemia in 24 and hypoglycemia in 22. Bone marrow hypoplasia was frequent, with leu kopenia in 29 patients, anemia in 21 and thrombocytopenia in 5. No pat ient developed infectious complications. One patient presented with an acute gastric dilatation and another with spontaneous pneumome-diasti num. One patient, 14 year-old, died 3 years after the onset of anorexi a from acute water intoxication. Conclusion. These well-known complica tions are more common in anorexic than in bulimic patients. Their prev ention requires rigorous and continuous medical supervision.