Abordagem clínica e nutricional na anorexia nervosa: relato de caso

Clinical and nutritional evolution of an adolescent with nervous anorexia: case report

Abstract

Objective: To follow the evolution of clinical and nutritional state of an adolescent with nervous anorexia.
Case description: The case of nervous restrictive anorexia was evaluated retrospectively, during of
hospitalization and outpatient visit. The patient was monitored by multidisciplinary team of the University
Hospital located on Rio de Janeiro state. The most important clinical features were bradycardia, hypotension
and dehydration, occurred in two hospitalizations. Laboratory exams done at the both hospitalization didn’t
show typical changes found in nervous anorexia. In both admissions were used oral and enteral nutrition,
aiming to provide caloric and protein requirements necessary for nutritional rehabilitation. The caloric intake
was increased gradually, and didn’t occur refeeding syndrome. In the fi rst hospital discharge, the patient reached
the target of 75% of 50th percentile for height and weight. After discharge, she lost weight and 4,5 months
later, she was re-hospitalized, with weight and BMI values less than those of 1st hospitalization. However, in
the 2nd hospitalization didn’t reach the target of 75% of 50th percentile for weight and height until the hospital
discharge. She returned to outpatient treatment, which oscillated among improvement and relapse periods,
however remained clinically stable.Comments: The management of patient with nervous anorexia is hard
working, requiring a multidisciplinary team with regular exchanges of information among the professionals.