Intermittent Brugada syndrome in an anorexic adolescent girl

• Published in: Journal of cardiology cases Vol. 10; no. 3; pp. 81 - 84
• Main Authors: Docx, Martine K.F., MD, Loeys, Bart, MD, PhD, Simons, Annik, MD, Gewillig, Marc, MD, PhD, Proost, Dorien, PhD student, Van Laer, Lut, PhD, Mertens, Luc, MD, PhD
• Format: Journal Article
• Language: English
• Published: Japan Elsevier Ltd 01.09.2014; Japanese College of Cardiology
• Subjects: Anorexia nervosa; Brugada syndrome; Cardiovascular; Hypothermia; Iatrogenic; Weight loss; Iatrogenic; Anorexia nervosa; Brugada syndrome; Weight loss; Hypothermia
• ISSN: 1878-5409; 1878-5409
• DOI: 10.1016/j.jccase.2014.03.012

Abstract We report an anorexic adolescent girl with an intermittent Brugada syndrome. A 14-year-old anorexic girl with a body mass index (BMI) of 13.15 kg/m2 was admitted in the acute state of the disease with an ST elevation in V1 and V2, suggestive of Brugada syndrome. After 1 month of re-feeding, a control electrograph (ECG) was normal, but after an 8-month follow-up control with a nearly normal BMI, the ECG was again suggestive of Brugada syndrome. A genetic analysis of the gene SNC5A established a genetic change (p Leu 1582 pro), which provides the final explanation for the Brugada syndrome. Every rhythm problem in the acute state or during the re-feeding procedure deserves a strict follow-up to distinguish iatrogenic from heritable rhythm problems. < Learning objective: (i) We report the first case of a patient with anorexia nervosa with an intermittent Brugada syndrome. (ii) Moderate hypothermia can decrease the depolarization of pacemaker cells and cause ST-segment changes. (iii) Every rhythm problem in the acute state or during the re-feeding procedure deserves a strict follow-up to distinguish iatrogenic from heritable rhythm problems. (iv) A genetic analysis can make the distinction and is necessary to give advice for the future lifestyle of the patient.>