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Electrolyte Blood Press. 2011 Jun;9(1):32-7. doi: 10.5049/EBP.2011.9.1.32. Epub 2011 Jun 30.

Orthorexia nervosa with hyponatremia, subcutaneous emphysema, pneumomediastimum, pneumothorax, and pancytopenia.

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Division of Nephrology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.


30-year-old male was admitted with general weakness and drowsy mental status. He had eaten only 3-4 spoons of brown rice and fresh vegetable without salt for 3 months to treat his tic disorder, and he had been in bed-ridden state. He has had weight loss of 14 kg in the last 3 months. We report a patient with orthorexia nervosa who developed hyponatremia, metabolic acidosis, subcutaneous emphysema, mediastinal emphysema, pneumothorax, and pancytopenia and we will review the literature. Also, we mention to prevent refeeding syndrome, and to start and maintain feeding in malnourished patients.


hyponatremia; orthorexia nervosa; pancytopenia; refeeding syndrome; subcutaneous emphysema

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