神経性食欲不振症に合併したたこつぼ型心筋症疑い例

概要

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We report two cases of anorexia nervosa (AN) complicated with ampula cardiomyopathy. Case 1, a 33-year-old female with a body mass index (BMI) of 9.61 kg/m^2 experienced transient unconsciousness induced by hypoglycemia. This episode was followed by increased plasma levels of creatine kinase (CK) and CK-MB, and an inverted T wave on ECG. The patient recovered from these changes within four weeks. Case 2, a 17-year-old female with a BMI of 8.79 kg/m^2 also developed identical abnormalities. An ultracardiogram revealed asynergy at the cardiac apex. Abnormal findings were also detected by T1 and BMIPP scintigraphies and MIBG scintigraphy. Ten days later cardiac movement at UCG had normalized. These changes were consistent with previous reports of ampula cardiomyopathy. Of the 28 AN patients admitted to our department during the last year, only the 2 cases whose BMI of less than 10 kg/m^2 developed ampula cardiomyopathy. The other 26 patients had a BMI greater than 10 kg/m^2. The pathogenesis of ampula cardiomyopathy remains unknown. This report demonstrates that the condition may occur in patients with AN, especially in those with a BMI of less than 10 kg/m^2.
東京女子医科大学の論文