Severe anorexia nervosa in a 20-year-old male with pericardial effusion and cortical atrophy.

This case report describes a 20-year-old man with a severe presentation of anorexia nervosa. His case is unique in that he presented at 49% of his ideal body weight and had a body mass index (BMI) of 11.59. In addition, he had cognitive slowing on exam and had cortical atrophy on a head CT. Other medical complications included pericardial tamponade that was treated with an open window pericardiocentesis, hepatitis, and anemia. He was treated nutritionally, first with a Dobb-Hoff tube and then with oral feedings, as well as had group, individual, and family therapies. He responded well to treatment, his labs normalized and he was discharged at 75% of his ideal body weight after a weight increase of 40 pounds and after 106 days of hospitalization at our facility. In addition, a head CT was repeated and the cortical atrophy had resolved.