An unusual case of an atypical eating disorder masquerading as a serious multi-systemic illness

An early diagnosis and multidisciplinary team approach are mandatory in the management of eating disorders. Serious organic symptoms and nutritional effects can mimic a systemic illness, particularly in those with atypical presentations. A 15-y-old adolescent male presented with poor growth, low weight, abdominal pain and yellow pigmentation. Further bizarre multi-system symptomatology resulted in a protracted admission with multiple investigations. An initial diagnosis of teratoma proved negative on abdominal laparotomy. A multidisciplinary approach followed by a feeding challenge led to the diagnosis of an eating disorder. The disorder, although more common in girls and adolescents, is increasing in incidence in both males and younger children.

Atypical eating disorders are potentially serious and life-threatening illnesses, and paediatricians and psychologists should be aware of unusual presentations.