بی اشتهایی عصبی تظاهری از یک بیماری جدی در نوجوانان: گزارش یک مورد بالینی

نوع مقاله : گزارش مورد

نویسندگان

1 گروه تغذیه، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد ، مشهد، ایران

2 گروه تغذیه، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد ، مشهد ، ایران

3 گروه گوارش کودکان، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران

10.22038/mjms.2025.88159.5013

چکیده

چکیده
ایدز در نوجوانان یک چالش جدی بهداشتی است که نیازمند آگاهی، تشخیص زودهنگام و درمان مناسب است. با شناخت علائم و انجام آزمایش‌های لازم، می‌توان از پیشرفت بیماری جلوگیری کرد و کیفیت زندگی نوجوانان مبتلا را بهبود بخشید. در این گزارش موردی به بررسی یک مرود ایدز در نوجوان پرداخته شده است. بیمار پسر 17 ساله بدون سابقه بیماری زمینه ای قبلی، به دنبال اعتصاب غذا با کاهش وزن شدید، آنورکسیا نروزا، اسهال خونی و استفراغ به بیمارستان مراجعه کرد. بیمار تحت تغذیه درمانی پزشکی و اندو-کولونوسکوپی قرار گرفت و با توجه به کولیت فعال روده ابتدا با شک به IBD ودرنهایت با تشخیص HIV به بخش مربوطه منتقل شد. اقدامات تیمی درمان منجر به بهبودی نسبی علائم از جمله کاهش اشتها، اسهال، درد عضلانی شد. تغذیه بهینه می‌تواند به حفظ توده بدون چربی بدن، کاهش شدت علائم مرتبط با HIV، افزایش پشتیبانی از درمان ضد رتروویروسی و بهبود کیفیت زندگی کمک کند. دستورالعمل‌های ESPEN بیان می‌کند که نیازهای انرژی باید در طول مرحله بهبودی پس از عفونت‌های فرصت‌طلب 20 تا 30 درصد افزایش یابد. این دستورالعمل‌ها مصرف پروتئین 1.2-1.5 گرم بر کیلوگرم را به ترتیب در فاز فعال و فاز غیر فعال این بیماری توصیه می‌کند.همچنین مواد ریزمغذی از جمله ویتامین ها C و D نقش مهمی در بهبود سلامت سیستم ایمنی در این بیماران دارد و در کنترل علائم بیماری ایدز از جمله التهاب و کاهش علائم گوارشی از جمله اسهال میتواند اثر بخش باشد.

کلیدواژه‌ها

عنوان مقاله [English]

Anorexia Nervosa as a Manifestation of a Serious Illness in Adolescents: A Clinical Case Report

نویسندگان [English]

  • Samira Mawdoodi 1
  • parastoo Asghari 2
  • Hamid Reza Kianifar 3
  • saeedeh talebi 2
1 Department of Nutrition, faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2 Department of Nutrition, faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
3 Department of Pediatrics, faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
چکیده [English]

Abstract

AIDS in adolescents presents a significant health challenge that necessitates awareness, early diagnosis, and appropriate treatment. By recognizing the symptoms and conducting the necessary tests, the progression of the disease can be halted, and the quality of life for affected adolescents can be enhanced. This case report examines an instance of AIDS in an adolescent. A 17-year-old male patient, with no prior history of underlying health issues, was admitted to the hospital following a hunger strike, which resulted in severe weight loss, anorexia nervosa, bloody diarrhea, and vomiting. The patient received medical nutrition therapy and underwent endo-colonoscopy, subsequently being transferred to the relevant department due to active colitis. Initially suspected to have inflammatory bowel disease (IBD), he was ultimately diagnosed with HIV. Team-based treatment measures resulted in partial improvement of symptoms, including reduced appetite, diarrhea, and muscle pain. Optimal nutrition is crucial for maintaining lean body mass, alleviating the severity of HIV-related symptoms, supporting antiretroviral therapy, and enhancing overall quality of life. According to ESPEN guidelines, energy requirements should increase by 20 to 30% during the recovery phase following opportunistic infections. These guidelines also recommend a protein intake of 1.2-1.5 g/kg during both the active and inactive phases of the disease. Additionally, micronutrients, such as vitamins C and D, play a vital role in bolstering immune system health in these patients and can effectively help manage AIDS symptoms, including inflammation and gastrointestinal issues like diarrhea.

کلیدواژه‌ها [English]

  • AIDS disease
  • anorexia nervosa
  • adolescent
  • nutrition therapy

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مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
دوره 69، شماره 5
مرداد1405
مرداد 1405
صفحه 482-494

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