Thomas Iv Lewis J, Zweig Alex P, Tosh Aneesh K
Int J Adolesc Med Health. 2014;26(2):293-5. doi: 10.1515/ijamh-2013-0506.
A 13-year-old Hispanic female presented with symptoms of abdominal pain, amenorrhea, and unintentional weight loss of 11 kg. Preliminary investigation yielded no immediate causes, and an initial differential included inflammatory bowel disease (IBD), celiac disease, as well as viral, bacterial, or parasitic gastrointestinal infection. Evaluation of these potential diagnoses yielded negative results; thus, the team thought that the patient may be suffering from anorexia nervosa. The patient was discharged to outpatient care, and was treated in our adolescent health clinic, where repeat laboratory testing yielded a positive Giardia-antigen test. The patient was placed on metronidazole, rapidly gained weight, and resumed menstruation soon after. The final diagnosis was chronic giardiasis. Chronic giardiasis is a rare and enigmatic disease that presents with many symptoms similar to chronic gastrointestinal disorders (e.g. IBD and celiac disease) and anorexia nervosa. Practitioners involved in the diagnosis and treatment of anorexia nervosa should be aware of this disorder and include it in differential diagnoses of patients presenting with anorexia nervosa symptoms.
一名13岁的西班牙裔女性出现腹痛、闭经以及11公斤的非故意体重减轻症状。初步调查未发现直接病因，初步鉴别诊断包括炎症性肠病（IBD）、乳糜泻以及病毒、细菌或寄生虫引起的胃肠道感染。对这些潜在诊断的评估结果均为阴性；因此，医疗团队认为该患者可能患有神经性厌食症。患者出院接受门诊治疗，并在我们的青少年健康诊所接受治疗，在那里重复实验室检测结果显示贾第鞭毛虫抗原检测呈阳性。患者接受甲硝唑治疗后体重迅速增加，并很快恢复月经。最终诊断为慢性贾第虫病。慢性贾第虫病是一种罕见且难以捉摸的疾病，其表现出许多与慢性胃肠道疾病（如IBD和乳糜泻）以及神经性厌食症相似的症状。参与神经性厌食症诊断和治疗的从业者应了解这种疾病，并将其纳入出现神经性厌食症症状患者的鉴别诊断中。
