Iqbal Tooba, Asif Musab, Saghir Farzeen, Mubarik Arslan, Saleem Ayma
Psychiatry and Behavioral Sciences, Nishtar Medical University, Multan, PAK.
Cardiology, Nishtar Medical University, Multan, PAK.
Cureus. 2025 Jun 19;17(6):e86378. doi: 10.7759/cureus.86378. eCollection 2025 Jun.
Non-bacterial thrombotic endocarditis (NBTE) is a rare complication typically seen in association with malignancies, autoimmune diseases, and hypercoagulable states. Its occurrence in the context of severe malnutrition, particularly in anorexia nervosa, is extremely uncommon. This case describes a 28-year-old woman with a long-standing history of anorexia nervosa (restrictive subtype), who presented with fatigue, dizziness, and chest discomfort. Clinical examination revealed a systolic murmur, and echocardiography identified sterile vegetations on the mitral valve. Blood cultures were negative, and further evaluation ruled out malignancy and autoimmune disease, leading to a diagnosis of NBTE likely precipitated by profound malnutrition. The patient was managed with therapeutic anticoagulation, cautious nutritional rehabilitation, and intensive psychiatric support. Over a four-week hospitalization, she showed significant improvement in nutritional status and resolution of vegetations on follow-up imaging. This case highlights the need to consider NBTE in severely malnourished individuals and underscores the importance of a multidisciplinary approach to address both the medical and psychiatric dimensions of anorexia nervosa.
非细菌性血栓性心内膜炎（NBTE）是一种罕见的并发症，通常与恶性肿瘤、自身免疫性疾病和高凝状态相关。它在严重营养不良的情况下发生，尤其是在神经性厌食症中极为罕见。本病例描述了一名28岁女性，有长期神经性厌食症（限制型）病史，出现疲劳、头晕和胸部不适。临床检查发现收缩期杂音，超声心动图显示二尖瓣上有无菌性赘生物。血培养阴性，进一步评估排除了恶性肿瘤和自身免疫性疾病，诊断为可能由严重营养不良引发的NBTE。患者接受了治疗性抗凝、谨慎的营养康复和强化精神支持治疗。在四周的住院期间，她的营养状况有显著改善，随访影像学显示赘生物消失。本病例强调了在严重营养不良个体中考虑NBTE的必要性，并强调了采用多学科方法解决神经性厌食症的医学和精神层面问题的重要性。
