DOI: 10.36347/sjmcr.2018.v06i06.014

Pages: 412-413

The patient, a 54-year-old woman who could independently carry out her activities of daily living, was found in an unconscious state at home by her mother. She had suffered from malnutrition since she was a teenager. When emergency medical technicians checked her, she was in a state of cardiopulmonary arrest; thus, they performed basic cardiopulmonary resuscitation. Spontaneous circulation was obtained after one cycle of chest compression. When she was examined by medical personnel who were dispatched by a physician-staffed helicopter, she was in a hypoglycemic state (glucose level of 10 mg/dl). Glucose infusion was administered after securing a venous route. On arrival, her height was 157 cm, and her weight was 28 kg, which corresponded to a body mass index of 13.She was diagnosed with anorexia nervosa with severe malnutrition, hypoxic and hypoglycemic encephalopathy, Takotsubo cardiomyopathy, and liver dysfunction due to kwashiorkor after examinations. The post-admission course was eventful and treated by multidisciplinary treatment that included the administration of anabolic steroids. Her body weight eventually increased to 33 kg, and her anabolic steroid dose was tapered. She was transported to a local medical facility for rehabilitation and mental support on the 91st hospital day. Multidisciplinary treatment including the administration of anabolic steroids may help improve a critically ill condition in patients with anorexia nervosa.