Abstract
Anorexia nervosa (AN) is a potentially fatal condition that requires critical care management during the course of treatment. Recently, we treated 2 female patients with AN who developed hypophosphatemia during their stay in the ICU. The patients were aged 55 and 31 years. In course of time, they had developed consciousness disturbance while staying at home and were transferred to our hospital. On arrival, both the patients were in a state of shock. In spite of the measures taken to correct hypotension and hypoglycemia, their consciousness levels did not improve. As a result, they were admitted to the ICU. Both the patients showed low levels of interleukin-6 (IL-6) in blood tests, despite the septic shock. At first, their blood phosphorus levels were high. However, the phosphorus levels decreased sharply when nutritional support was started; this indicated a severe deficiency of phosphorus in their bodies. Both the patients responded well to the treatment, and they were transferred to general wards within 5 days. These results suggest that a mechanism involving modifications in the secretion pattern of IL-6 could explain some of the observations regarding the immunosuppressive function in underweight AN patients. We concluded that the restriction of energy intake, frequent monitoring of blood phosphorus levels, and phosphorus replenishment were important in the nutritional management of patients with AN.
