Rich L M, Caine M R, Findling J W, Shaker J L
Department of Medicine, St Luke's Medical Center, Milwaukee, WI 53215.
Arch Intern Med. 1990 Apr;150(4):894-5.
Clinically significant hypoglycemia is an unusual complication of anorexia nervosa. We describe a 44-year-old woman with a 5-year history of anorexia nervosa who presented with hypoglycemic coma and eventually experienced sudden death. Biochemical studies showed suppressed levels of insulin, C peptide, and proinsulin during hypoglycemia; appropriate elevations of growth hormone and cortisol levels were observed, suggesting that the hypoglycemia was related to severe malnutrition. Nine previously reported cases of severe hypoglycemia in anorexia nervosa are reviewed (six of the patients involved also died). The presence of severe hypoglycemia in anorexia nervosa implies a grave prognosis and mandates aggressive medical and nutritional therapy to improve the chance of survival.
具有临床意义的低血糖是神经性厌食症的一种罕见并发症。我们报告一名44岁患有神经性厌食症5年的女性，她出现低血糖昏迷并最终猝死。生化研究显示，低血糖期间胰岛素、C肽和胰岛素原水平受到抑制；观察到生长激素和皮质醇水平适当升高，提示低血糖与严重营养不良有关。本文回顾了先前报道的9例神经性厌食症严重低血糖病例（其中6例患者也死亡）。神经性厌食症患者出现严重低血糖意味着预后不良，需要积极的医学和营养治疗以提高生存几率。
