Abstract
This clinical case describes a 13-year-old female who presents with secondary amenorrhea. She has lost 3 kg since age 12, but on close examination of her growth charts, this seemingly small amount of weight loss at a time of expected rapid growth translates into a significant decrease in BMI percentile. Her history, vital signs, physical exam, and laboratory work are consistent with a diagnosis of anorexia nervosa. Untreated anorexia can lead to grave outcomes such as osteopenia, cardiac arrest, suicide, infertility, and the development of chronic anorexia nervosa that becomes refractory to treatment. The most effective treatment is aggressive nutritional rehabilitation through the administration of nutrient-dense meals. Family-based treatment is the most evidence-based modality for refeeding anorexic adolescents, especially those who are young with a short duration of illness. It is imperative that parents understand the gravity of this diagnosis and the need for timely and aggressive treatment.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Golden NH, Carlson JL. The pathophysiology of amenorrhea in the adolescent. Ann N Y Acad Sci. 2008;1135:163–78. https://doi.org/10.1196/annals.1429.014.
Winston AP. The clinical biochemistry of anorexia nervosa. Ann Clin Biochem. 2012;49(2):132–43. https://doi.org/10.1258/acb.2011.011185.
Misra M, Golden NH, Katzman DK. State of the art systematic review of bone disease in anorexia nervosa. Int J Eat Disord. 2016;49(3):276–92. https://doi.org/10.1002/eat.22451.
Golden NH, Lanzkowsky L, Schebendach J, Palestro CJ, Jacobson MS, Shenker IR. The effect of estrogen-progestin treatment on bone mineral density in anorexia nervosa. J Pediatr Adolesc Gynecol. 2002;15(3):135–43. https://doi.org/10.1016/S1083-3188(02)00145-6.
Misra M, Katzman D, Miller KK, et al. Physiologic estrogen replacement increases bone density in adolescent girls with anorexia nervosa. J Bone Miner Res. 2011;26(10):2430–8. https://doi.org/10.1002/jbmr.447.
DiVasta AD, Feldman HA, Beck TJ, LeBoff MS, Gordon CM. Does hormone replacement normalize bone geometry in adolescents with anorexia nervosa? J Bone Miner Res. 2014;29(1):151–7. https://doi.org/10.1002/jbmr.2005.
Lock J, Le Grange D, Agras WS, Moye A, Bryson SW, Jo B. Randomized clinical trial comparing family-based treatment with adolescent-focused individual therapy for adolescents with anorexia nervosa. Arch Gen Psychiatry. 2010;67:1025–32. https://doi.org/10.1001/archgenpsychiatry.2010.128.
Lock JD, Legrange D. Anorexia nervosa in adolescents: a treatment manual. 2nd ed. New York: The Guilford Press; 2013.
Accurso EC, Ciao AC, Fitzsimmons-Craft EE, Lock JD, Le Grange D. Is weight gain really a catalyst for broader recovery?: The impact of weight gain on psychological symptoms in the treatment of adolescent anorexia nervosa. Behav Res Ther. 2014;56:1–6. https://doi.org/10.1016/j.brat.2014.02.006.
Pitts S, Blood E, Divasta A, Gordon CM. Percentage body fat by dual-energy x-ray absorptiometry is associated with menstrual recovery in adolescents with anorexia nervosa. J Adolesc Health. 2014;54(6):739–41. https://doi.org/10.1016/j.jadohealth.2013.12.033.
Suggested Educational Reading and References
Campbell KA, Peebles R. Eating disorders in children and adolescents: state of the art review. Pediatrics. 2014;134(3):582–92.
Katzman DK, Peebles R, Sawyer SM, Lock J, Le Grange D. The role of the pediatrician in family-based treatment for adolescent eating disorders: opportunities and challenges. J Adolesc Health. 2013;53:433–40.
Maudsley Parents website: www.maudsleyparents.org
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG
About this chapter
Cite this chapter
Dodson, N.A. (2018). Case of a Girl with Secondary Amenorrhea and an Eating Disorder. In: Talib, H.J. (eds) Adolescent Gynecology. Springer, Cham. https://doi.org/10.1007/978-3-319-66978-6_10
Download citation
DOI: https://doi.org/10.1007/978-3-319-66978-6_10
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-66977-9
Online ISBN: 978-3-319-66978-6
eBook Packages: MedicineMedicine (R0)