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Severe refeeding syndrome after human chorionic gonadotropin diet: a potentially lethal complication
Max J Schunemann1, Martina Bertschinger2, Christian Trachsel3
1Department of Internal Medicine, University Hospital Basel, Basel, Switzerland max.schuenemann@usb.ch.
BMJ Case Reports
|November 18, 2021
Summary
Severe calorie restriction, such as the human chorionic gonadotropin (hCG) diet, can lead to dangerous electrolyte imbalances and refeeding syndrome. Prompt electrolyte correction resolved paralysis and rhabdomyolysis in a young male patient.
Area of Science:
- Endocrinology
- Metabolic Disorders
- Clinical Case Reports
Background:
- Severe calorie restriction diets are popular for weight loss.
- The human chorionic gonadotropin (hCG) diet involves very low caloric intake.
- Potential metabolic complications of extreme diets are not always recognized.
Observation:
- A young male presented with paralyzing muscle weakness.
- Initial investigations did not reveal the cause of symptoms.
- Patient history revealed recent adherence to a severe calorie-restricted hCG diet.
Findings:
- The patient was diagnosed with severe refeeding syndrome.
- Severe hypokalemia and hypophosphatemia were identified as key electrolyte disturbances.
- Rhabdomyolysis developed as a complication.
- Symptoms resolved completely after electrolyte correction.
Implications:
- This case highlights the significant risks associated with severely calorie-restricted diets like the hCG diet.
- Refeeding syndrome is a critical consideration in patients with a history of malnutrition or extreme dieting.
- Thorough patient history taking is crucial for accurate diagnosis and management of iatrogenic conditions.
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