The refeeding syndrome and glucose load.
OBJECTIVE
A 10-year-old girl with anorexia nervosa developed the refeeding syndrome following cautious reintroduction of nutrition, emphasizing that even with cautious refeeding a shift in fluid, glucose, and electrolytes can still occur, increasing the risk of morbidity and mortality in this ever growing vulnerable group.


METHODS
Biochemical, nutritional, and anthropometrical monitoring in the patient, who followed a conservative refeeding program after a prolonged period of nutritional inadequacy.


RESULTS
The refeeding syndrome presented itself with hypophosphatemia, hypotension, and cardiac abnormalities whilst refeeding at 25 kcal/kg (600 kcal/day).


CONCLUSIONS
Comprises of a literature review, highlighting this case as the youngest reported case of refeeding syndrome in anorexia nervosa. Discussion focuses on the possible deleterious affects that carbohydrates may have in exacerbating the refeeding syndrome.
O'Connor
Graeme
G
Division of Nutrition and Dietetics, Great Ormond Street Children's Hospital, London, United Kingdom. graeme.oconnor@nhs.net
Goldin
Jonathon
J
D000856:Anorexia Nervosa / Q000628:therapy*; D002648:Child; D004750:Enteral Nutrition / Q000009:adverse effects*; D005260:Female; D006801:Humans; D017674:Hypophosphatemia / Q000209:etiology* / Q000628:therapy; D055677:Refeeding Syndrome / Q000209:etiology* / Q000628:therapy; D016896:Treatment Outcome