Anorexia nervosa is an eating disorder characterized by the avoidance of food intake, which usually leads to a weight loss. Cardiac co-morbility is common and we can find sometimes a mass loss from the left ventricle, which can be seen by echocardiography. But the commonest complications are rhythm variations, typically bradycardia with a prolonged QT interval in up to a 40% of the cases, which altogether elevates ventricular tachycardia and sudden death risk. We present the case of a male who was diagnosed with anorexia nervosa and developed asthenia, a long QT interval and also a severe both hypokalaemia and hypomagnesaemia. We intend to discuss the pathogenic paths as well as prophylactic and therapeutic measures to this potentially-lethal pathology.

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RESUMENCaso clínico: La oftalmopatía por enfermedad de Graves (exoftalmos, infiltración muscular y palpebral) se asocia casi sistemáticamente a hipertiroidismo. Paciente diagnosticada de hipotiroidismo subclíni-co y tratada adecuadamente con tiroxina oral. Unos meses después desarrolla un exoftalmos bilateral y simultáneamente presenta anticuerpos séricos antireceptor de TSH positivos. Se suspende entonces el tratamiento con tiroxina, y se comprueba que el hipotiroidismo ha progresado hasta hacerse primario. Se establece el diagnóstico de enfermedad de Graves hipotiroidea. Discusión: El diagnóstico se basó en la existencia de la oftalmopatía y los anticuerpos positivos, ambos específicos de la enfermedad de Graves. La coexistencia de hipotiroidismo es excepcional, pero posible.Palabras clave: Oftalmopatía por enfermedad de Graves, hipotiroidismo, anticuerpos anti-receptor de tirotropina, tiroxina, terapéutica. COMUNICACIÓN CORTA ABSTRACTClinical case: Graves´ ophthalmopathy (exophthalmos, muscular and eyelid infiltration) is associated almost systematically to hyperthyroidism. A female patient was diagnosed with subclinical hypothyroidism and treated with oral thyroxine. Months later she developed bilateral exophthalmos and was serum-positive for thyrotropin receptor antibodies. Thyroxine treatment was suspended, and it was verified that her condition had developed into primary hypothyroidism. A diagnosis of Graves' disease with hypothyroidism was made. Discussion: The diagnosis was based on the existence of ophthalmopathy and positive serum antibodies, both specific indicators of Graves' disease. The coexistence of hypothyroidism with Graves' disease is exceptional, but possible (Arch Soc Esp Oftalmol 2007; 82: 765-768).

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