Mimura Yu, Shimizu Yusuke, Oi Hiroki, Kurose Shin, Kudo Shun, Takata Taketo, Mimura Masaru, Funayama Michitaka
Department of Neuropsychiatry, Japanese Red Cross Ashikaga Hospital, 49-1 Yobe-Cho, Ashikaga-shi, Tochigi, 326-0843, Japan.
Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
J Eat Disord. 2021 Mar 20;9(1):39. doi: 10.1186/s40337-021-00393-w.
Numerous reports have indicated that patients with anorexia nervosa (AN) are at a relatively high risk of developing vascular diseases, including cardiovascular events and venous thromboembolism. However, there have been no previous reports of the development of ischemic stroke during refeeding therapy in patients with severe AN. This report is aimed at reporting the characteristics of an ischemic stroke in patients with AN.
Our study included 29 admissions by independent 19 female patients cases (19 patients), who received thorough medical, neurological, and psychiatric examinations. Two patients were diagnosed as having developed ischemic stroke; the first patient showed multiple infarctions in the brain, while the second showed symptomatic focal infarction. Our findings suggest that dehydration and arteriosclerosis, in association with severe malnutrition, could predispose to the development of ischemic stroke in patients with severe AN.
Development of ischemic stroke in patients with AN might be overlooked. Watching out for neurological signs would help in early diagnosis of ischemic stroke in patients with AN during refeeding. Specific etiology could induce ischemic stroke in patients with AN even if they have no common risk factors of ischemia.
大量报告表明，神经性厌食症（AN）患者发生血管疾病的风险相对较高，包括心血管事件和静脉血栓栓塞。然而，此前尚无关于重度AN患者在重新进食治疗期间发生缺血性中风的报告。本报告旨在报道AN患者缺血性中风的特征。
我们的研究纳入了19例独立的女性患者（共29次入院），这些患者接受了全面的医学、神经学和精神科检查。两名患者被诊断为发生了缺血性中风；第一名患者脑部出现多处梗死，而第二名患者出现有症状的局灶性梗死。我们的研究结果表明，脱水和动脉硬化与严重营养不良相关，可能使重度AN患者易发生缺血性中风。
AN患者缺血性中风的发生可能被忽视。留意神经学体征有助于在重新进食期间对AN患者的缺血性中风进行早期诊断。即使没有常见的缺血风险因素，特定病因也可能导致AN患者发生缺血性中风。
