Uncommon presentation of hypoglycemic coma in a pregnant patient with anorexia nervosa: a case report.

Introduction and importance: Anorexia nervosa (AN) patients are at risk for multiple complications requiring hospital admission, such as hypoglycemia. Although AN largely affects females, reports of its complications in pregnancies are rare. To the best of our knowledge, this is the first report of AN complicated by hypoglycemic coma in pregnancy. Case presentation: We report a case of a 27-year-old pregnant patient with AN who presented to the emergency department with hypoglycemic coma. She was started on intravenous fluids and underwent several diagnostic procedures, which showed a random blood sugar result of 10 mg/dl. The patient had significant clinical improvement after fluid resuscitation and was discharged on her regular medications. There were no more complications during the pregnancy, and it resulted in the birth of a 2.5 kg girl at term. Clinical discussion: AN complicated by hypoglycemia could be asymptomatic or present with signs of sympathetic stimulation. The acute management of this condition requires the administration of dextrose-containing IV fluids and continuous monitoring of blood sugar levels. Furthermore, AN in pregnancy may cause a range of maternal and fetal complications. Thus, long-term management requires a multidisciplinary approach consisting of a team of obstetricians, nutritionists, and psychiatrists. Conclusion: Hypoglycemic coma is a fatal complication of AN in pregnant patients. Despite not knowing the exact mechanism, rapid recognition and intervention ensure the prevention of further complications and require appropriate weight gain and psychosocial support.