A patient with anorexia nervosa may develop a pericardial effusion.
The pathogenesis is uncertain. One theory associates it with the low T3 syndrome. Another suggests severe protein malnutrition.
Many patients are asymptomatic. Occasionally a patient may develop tamponade.
Echocardiography is a sensitive means of detection.
Risk factors:
(1) body mass index <= 13.5 kg per square meter
(2) weight loss >= 25% of previous weight
(3) serum IGF-1(insulin-like growth factor) concentration <= 100 ng/mL
The effusion resolves with successful refeeding.
Differential diagnosis:
(1) pericardial disease from other cause
