Achalasia mimicking prepubertal anorexia nervosa

Authors

  • Andreas Richterich,

    Corresponding author
    1. Department of Child and Adolescent Psychiatry, University of Heidelberg, Heidelberg, Germany
    • Department of Child and Adolescent Psychiatry, University of Heidelberg, Blumenstr. 8, 69115 Heidelberg, Germany
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  • Romuald Brunner,

    1. Department of Child and Adolescent Psychiatry, University of Heidelberg, Heidelberg, Germany
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  • Franz Resch

    1. Department of Child and Adolescent Psychiatry, University of Heidelberg, Heidelberg, Germany
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Abstract

A 9-year-old girl presents for continuing weight loss of 10kg over the course of 1 year. Medical history showed three episodes of pneumonia requiring hospital admission in the 6 months before presentation and 4 months of weekly psychotherapy for anorexia nervosa. A thorough history of eating behavior and a review of systems revealed not only typical aspects of prepubertal anorexia nervosa but also vomiting at night while asleep, difficulty drinking liquids, epigastric pain, and a frequent experience of “a lump in the throat”; these symptoms were not suggestive of a diagnosis of anorexia nervosa but rather of esophageal achalasia. The patient was transferred to the Department of Pediatrics, and a diagnosis of esophageal achalasia was made by chest x-ray and barium swallow. After dilatation and botulinum toxin application, the patient regained weight easily and was discharged in stable condition. In this case, esophageal achalasia mimicked prepubertal anorexia nervosa. © 2003 by Wiley Periodicals, Inc. Int J Eat Disord 33: 356–359, 2003.

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