Anorexia nervosa and Raynaud's phenomenon: a case report.
OBJECTIVE
To describe and discuss potential relationships between anorexia nervosa (AN) and Raynaud's phenomenon, the course and concurrent treatment of these two disorders as they appeared simultaneously, and a potential treatment modification entailed in such concurrent therapies.


BACKGROUND
Although Raynaud's phenomenon has been described during the course of AN, the associations and interactions between these two conditions are not clear.


METHODS
We report the medical workup, treatment, and outcomes in a 19-year old female patient who developed Raynaud's phenomenon following the onset of AN.


RESULTS
After treatment with nutritional rehabilitation, counseling, and individual and group therapy, the patient's weight, eating disorder-related behaviors, and attitudes improved significantly. Raynaud's related symptoms improved, following treatment with a calcium channel blocker and antiaggregant therapy. In conjunction with nutritional efforts to treat the patient's long-standing amenorrhea and osteopenia, the treatment team elected to also administer estrogen hormone in addition to oral calcium and vitamin D supplementation. Since oral contraceptives are to be avoided in patients with Raynaud's phenomenon who show clinical findings suggesting connective tissue disorder, the treatment team elected to treat this patient with transdermal hormone replacement therapy.


CONCLUSIONS
The co-occurrence of AN and Raynaud's phenomenon merits close and persistent follow-up by a multidisciplinary team and may lead to alterations of usual therapeutic approaches.
Yucel
Basak
B
Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. byucel@superonline.com
Uzum
Ayse Kubat
AK
Ozbey
Nese
N
Kamali
Sevil
S
Yager
Joel
J
D000279:Administration, Cutaneous; D000328:Adult; D000568:Amenorrhea / Q000209:etiology / Q000628:therapy; D000856:Anorexia Nervosa / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D001241:Aspirin / Q000627:therapeutic use; D015519:Bone Density / Q000187:drug effects; D001851:Bone Diseases, Metabolic / Q000209:etiology / Q000628:therapy; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003376:Counseling; D015914:Estrogen Replacement Therapy; D005196:Family Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009543:Nifedipine / Q000627:therapeutic use; D044623:Nutrition Therapy; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011613:Psychotherapy; D011615:Psychotherapy, Group; D011928:Raynaud Disease / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy
D002121:Calcium Channel Blockers; D010975:Platelet Aggregation Inhibitors; D009543:Nifedipine; D001241:Aspirin