Severe bronchiectasis and inflammatory lung disease in a patient with anorexia nervosa and severe and enduring malnutrition - a case report

Abstract

Background Persistent structural changes of the lungs in anorexia nervosa (AN) patients are rarely described in contemporary medical literature. The objective of our paper is to report a rare case of severe bronchiectasis and inflammatory changes to the lungs resulting from chronic malnutrition in a AN patient. Case presentation We describe a patient with severe inflammatory lung disease caused by malnutrition, resulting in persistent bronchiectasis accompanying AN. We performed an analysis of the patient’s medical records including radiological findings and laboratory results. A review of available literature shows very little data available on this topic. Conclusion Bronchiectasis and other structural changes of the lungs are rare, but severe complications of severe, chronic malnutrition. As exemplified by our case report, they may require extensive differential diagnosis and pose a significant clinical challenge due to their non-reversible character. A successful treatment relies heavily on the patient’s compliance and may be hard to achieve. Clinicians managing patients with anorexia nervosa should be wary of early respiratory tract dysfunction-related symptoms and always consider malnutrition bronchiectasis as a differential diagnosis option.

Pulmonary complications of eating disorders: a literature review

“…Bullous emphysema and bronchiectasis have also been reported and attributed to severe malnutrition in a 30-year-old male with AN presenting at 43% IBW [ 39 ]. Several other case reports have documented findings of emphysema and/or bronchiectasis in severely malnourished patients, each about 50% of IBW [ 40 , 41 ].…”

“…Nml DLCO Imaging: None Ryan et al 42 ] * Case report 1 AN-R 25 46% IBW F PFTs: Restrictive pattern; reduced RMS, reduced ventilatory response to hypercapnia. All improved c̅ refeeding Imaging: Nml CXR Saran et al [ 40 ] ± Case report 1 AN-R 30 BMI 9.2 kg/m2 F PFTs: none. Imaging: CT c̅ Bronchiectasis Sheu et al [ 41 ] * Case report 1 AN-BP 18 BMI 10.2 kg/m2 F PFTs: Reduced RMS.…”