Evidence map›Paper›PMID 31522380›Full record

ReviewEating and weight disorders : EWD2020

Sounds unrealistic: an adolescent girl with anorexia nervosa consumes 19 L of fluid in a few hours: what happens to the physiology?

Alkim Oden Akman, H Tuna Cak, Melis Pehlivantürk-Kızılkan, Zeynep Balik, Ozlem Akbulut, Nuray Kanbur

Abstract readCase ReportsReview
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In one paragraph

Review in Eating and weight disorders : EWD, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact, top 84% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 5 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Alkim Oden AkmanDepartment of Pediatrics, Ankara Child Health and Diseases Hematology and Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
H Tuna CakDepartment of Child and Adolescent Psychiatry, Hacettepe University School of Medicine, Ankara, Turkey.
Melis Pehlivantürk-KızılkanDepartment of Pediatrics, Division of Adolescent Medicine, Hacettepe University School of Medicine, Ankara, Turkey.
Zeynep BalikDepartment of Pediatrics, Hacettepe University School of Medicine, Ankara, Turkey.
Ozlem AkbulutDepartment of Pediatrics, Başkent University School of Medicine, Ankara, Turkey.
Nuray KanburDepartment of Pediatrics, Division of Adolescent Medicine, Hacettepe University Ihsan Dogramaci Children's Hospital, Hacettepe University School of Medicine, Ankara, Turkey. nuraykanbur@hotmail.com.
Hacettepe University · TRBaşkent University · TRMinistry of Health · TR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAdolescents with eating disorders (EDs) may present not only with abnormal eating behaviors but also with abnormal drinking behaviors varying widely. These behaviors include water loading to cheat on weight measurements, to feel full and suppress appetite and/or to induce vomiting; as well as restricting fluid intake in addition to food.

methodWe present a 16-year-old female adolescent with anorexia nervosa restrictive type and major depressive disorder who was hospitalized due to acute food refusal and developed generalized seizures due to dilutional hyponatremia in consequence of consuming excessive amount of water. Psychiatric diagnoses were made according to 'The Diagnostic and Statistical Manual of Mental Disorders' (5th ed.; DSM-5) criteria.

resultsAfter starting nutritional rehabilitation with a low calorie meal plan to avoid refeeding syndrome, a weight gain of 2 kg was noted in the second day of hospitalization. At the bedside visit, she was observed in a disoriented manner and consecutively in seconds, lost consciousness with a generalized tonic-clonic seizure lasting 2 min. Her serum sodium level was measured as 116 mEq/L, which was normal at the time of admission. It was later learned that she secretly ingested 19 L of water in a short amount of time. She regained consciousness and no further seizures were observed after intravenous sodium deficit correction and fluid restriction therapy. Her serum sodium level was normalized (137 mEq/L) within 12 h.

conclusionA thorough clinical assessment of hydration and drinking behaviors as well as eating behaviors is essential for patients with EDs to avoid serious medical complications with high mortality and morbidity during follow-up. It is interesting that this amount of fluid consumption in such a short period of time did not present to the clinic with vomiting, gastric dilatation or bowel irrigation symptoms in a case with acute food refusal and restriction for a year, instead absorbed very quickly causing acute and severe symptomatic hyponatremia with generalized seizures.

Indexed as

Anorexia NervosaFeeding and Eating DisordersHyponatremiaMajor Depressive DisorderAdolescentFemaleHumansSeizuresAdolescentAnorexia nervosaHyponatremiaSeizureWater intoxication

Identifiers

PMID31522380
OpenAlexW2972443838

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.