Gastric neoplasia misdiagnosed as an eating disorder

Abstract

Presents a case report of 28-year-old female patient, a ballet teacher and professional dancer, who was hospitalized in March 2008 with a diagnosis of anorexia nervosa. Two years prior to hospitalization, she had been presenting episodes of spontaneous emesis after meals followed by an 18 kg weight loss. She underwent psychiatric evaluation and treatment, in which the diagnoses of anorexia nervosa and bipolar disorder were made. Five months prior to hospitalization, she presented a 20 kg weight loss and approximately 10 spontaneous emesis episodes per day, including during the night. She sought psychiatric treatment again, without improvement. She had also presented alopecia, intestinal constipation, excessive thirst and amenorrhea four months prior to hospitalization. Her work activities were interrupted one month prior to hospitalization due to feelings of sadness and weakness. On the day before hospitalization, she sought the emergency room with dehydration, when she was directed to our facilities. The patient presented some eating disorder risk factors, such as being a female, presenting amenorrhea, familiar instability and previous history of psychiatric disorders. Furthermore, she is a ballet teacher and performer, and thus lives in a situation in which there is social pressure to keep body weight under control. Eating disorders are more prevalent in high performance athletes, and may affect 31% of dancers. These epidemiological data, the initial clinical improvement and the interruption of the treatment may have induced physicians not to perform a gastrointestinal investigation, which resulted in an anorexia nervosa misdiagnosis. This case displays a rare occurrence of gastric neoplasia misdiagnosed as an eating disorder. (PsycINFO Database Record (c) 2012 APA, all rights reserved)