{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T06:11:10Z","timestamp":1771654270268,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2009,2,26]],"date-time":"2009-02-26T00:00:00Z","timestamp":1235606400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Intl J Eating Disorders"],"published-print":{"date-parts":[[2010,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives:<\/jats:title><jats:p>To illustrate the close association between a disturbed psychosocial up\u2010bringing, frequent physical illness, and medical interventions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method:<\/jats:title><jats:p>We report a case of a 44\u2010year\u2010old woman with anorexia nervosa (AN) and Sheehan's syndrome who died as a result of a toxic cardiac arrest.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>The patient presented with a BMI of 13.6 kg\/m<jats:sup>2<\/jats:sup>. She refused any intensive\u2010care treatment and died from toxic cardiac arrest. Postmortem examination revealed an acute gastroenterocolitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion:<\/jats:title><jats:p>The history of this patient illustrates how psychological deprivation led to eating disturbances, early pregnancy, and the life\u2010threatening delivery of twins. This resulted in a diagnosis of Sheehan's syndrome, hepatitis C, and a ventricular ulcer. A psychosocial event triggered a late exacerbation of her AN. A helpful alliance between patient and staff did not occur as she rejected it. \u00a9 2009 by Wiley Periodicals, Inc. 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