Abstract
A 29-year-old woman was admitted in January, 1991, because of emaciation. She had had 6 episodes of fasting hypoglycemia, and the final event was severe coma. She was diagnosed as having anorexia nervosa, because there was no evidence of organic disease causing emaciation. After intravenous hyperalimentation was performed, she was discharged at a body weight of 35kg. One year later, she was readmitted because of weight loss to 25kg and gait disturbance. She had hypoglycemic shock on the third morning of admission. She was treated by intratracheal canalization and intravenous administration of glucose. Although sufficient weight gain was not obtained by intravenous hyperalimentation, she was treated successfully by operant conditioning using self-recording of daily body weight change on a graph. She gained weight up to 43kg and was discharged.
Although fasting hypoglycemic coma is a rare event in anorexia nervosa, prolonged fasting in patients who reject food intake and drip infusion of glucose should be avoided, since hypoglycemia may lead to sudden death.
