Portal hypertension in prolonged anorexia nervosa with laxative abuse: A case report of three patients

Autor:	Masatoshi Imamura, Sunao Matsuubayashi, Keita Tatsushima, Keisuke Kawai, Naho Tamura, Aiko Koga, Kenta Toda
Rok vydání:	2019
Předmět:	medicine.medical_specialty laxatives Cirrhosis liver diseases business.industry portal hypertension eating disorders Anorexia medicine.disease Collateral circulation Gastroenterology anorexia nervosa Psychiatry and Mental health Eating disorders Anorexia nervosa (differential diagnoses) Internal medicine case reports Ascites medicine Vomiting Portal hypertension Clinical Case Report medicine.symptom business liver fibrosis
Zdroj:	The International Journal of Eating Disorders
ISSN:	0276-3478
DOI:	10.1002/eat.23007
Popis:	Objective There has been no report on portal hypertension related to anorexia nervosa (AN). Method We describe three cases of portal hypertension manifesting with collateral circulation represented by gastroesophageal varices in prolonged AN with laxative abuse and self‐vomiting. These women, in their 20s to 50s, were diagnosed as having AN binging and purging type (AN‐BP) that included self‐induced vomiting and abuse of irritating laxatives (more than 100 tablets daily). Results Case 1 showed prominent ascites and a gastro‐renal shunt on computed tomography scanning. Case 2 showed gastroesophageal varices on endoscopic examination. Case 3 showed gastroesophageal varices on computed tomography scanning and endoscopic examination. We performed liver biopsies in all patients and found only slight pericellular fibrosis. Our patients showed typical symptoms of portal hypertension, although liver cirrhosis was not present. Discussion We speculated that abnormal eating and purging behaviors were involved in the development of portal hypertension. We hypothesized that long‐term laxative abuse, dehydration, and abnormal eating behavior are involved in the development of portal hypertension, considering these were common features in our patients. Portal hypertension and gastroesophageal varices should be considered as one of the potentially existing complications in prolonged AN‐BP with self‐induced vomiting and abuse of irritating laxatives.
Databáze:	OpenAIRE
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