{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T06:17:53Z","timestamp":1772691473667,"version":"3.50.1"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Eat Disord"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Patients with avoidant\/restrictive food intake disorder (ARFID) commonly present with loss of weight or faltering growth in the setting of poor nutrition. However, patients with ARFID can present with micronutrient deficiencies without weight loss. In patients with ARFID, clinicians should be vigilant for micronutrient deficiencies and their presentations.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>We report a unique case of ARFID in a twelve-year-old girl, who developed micronutrient deficiencies and presented with acute visual loss with a preceding history of impaired night vision. Ophthalmic examination revealed xerophthalmia and bilateral optic neuropathy. Investigations showed severe Vitamin A and folate deficiencies which accounted for her clinical findings. In addition, she was also found to have low Vitamin B12, copper, and Vitamin D levels. She had a history of selective eating from a young age with a diet consisting largely of carbohydrates, with no regular intake of meat, dairy, fruit and vegetables. This was not driven by weight or body image concerns. The patient\u2019s symptoms improved significantly with appropriate vitamin replacement and continued multidisciplinary care.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This report describes a patient with ARFID presenting with visual complaints. In this case, the selective eating behaviours resulted in xeropthalmia and optic neuropathy. Micronutrient deficiencies are uncommon in developed countries. When these deficiencies are suspected, eating disorders, such as ARFID, should be considered. Similarly, clinicians caring for patients with restrictive eating disorders including ARFID should be familiar with the clinical presentations of various micronutrient deficiencies and consider evaluation and treatment for micronutrient deficiencies when clinically indicated.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40337-024-01042-8","type":"journal-article","created":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T05:25:50Z","timestamp":1719897950000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Xeropthalmia and optic neuropathy secondary to ARFID: a case report"],"prefix":"10.1186","volume":"12","author":[{"given":"Aletheia ZH","family":"Chia","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lim Su","family":"Ann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bryan","family":"Sim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Courtney","family":"Davis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,7,1]]},"reference":[{"key":"1042_CR1","unstructured":"Association AP. Diagnostic and Statistical Manual of Mental Disorders (5th ed) (DSM-5). American Psychiatric Publishing. 2013."},{"key":"1042_CR2","doi-asserted-by":"publisher","first-page":"112961","DOI":"10.1016\/j.psychres.2020.112961","volume":"288","author":"L Bourne","year":"2020","unstructured":"Bourne L, Bryant-Waugh R, Cook J, Mandy W. Avoidant\/restrictive food intake disorder: a systematic scoping review of the current literature. Psychiatry Res. 2020;288:112961.","journal-title":"Psychiatry Res"},{"key":"1042_CR3","doi-asserted-by":"crossref","unstructured":"Schmidt R, Hiemisch A, Kiess W, von Klitzing K, Schlensog-Schuster F, Hilbert A. Macro- and Micronutrient Intake in Children with Avoidant\/Restrictive food intake disorder. Nutrients. 2021;13(2).","DOI":"10.3390\/nu13020400"},{"key":"1042_CR4","doi-asserted-by":"crossref","unstructured":"Achamrah N, Coeffier M, Rimbert A et al. Micronutrient Status in 153 patients with Anorexia Nervosa. 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Int Ophthalmol Clin. 2000;40(4):83\u201391.","journal-title":"Int Ophthalmol Clin"},{"issue":"3","key":"1042_CR8","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1159\/000496603","volume":"235","author":"J Xiang","year":"2019","unstructured":"Xiang J, Wang H, Li T. Comorbidity of vitamin A and vitamin D Deficiency exacerbates the severity of atopic dermatitis in children. Dermatology. 2019;235(3):196\u2013204.","journal-title":"Dermatology"},{"key":"1042_CR9","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1146\/annurev.nutr.21.1.167","volume":"21","author":"CB Stephensen","year":"2001","unstructured":"Stephensen CB. Vitamin A, infection, and immune function. Annu Rev Nutr. 2001;21:167\u201392.","journal-title":"Annu Rev Nutr"},{"issue":"10","key":"1042_CR10","doi-asserted-by":"publisher","first-page":"1899","DOI":"10.1111\/jpc.16069","volume":"58","author":"GL Mahoney","year":"2022","unstructured":"Mahoney GL, Larcombe PJ, Ling J, Ashok Kumar A. Vitamin A deficiency in avoidant restrictive food intake disorder. J Paediatr Child Health. 2022;58(10):1899\u2013900.","journal-title":"J Paediatr Child Health"},{"issue":"3","key":"1042_CR11","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1016\/j.jand.2020.10.017","volume":"121","author":"S Yule","year":"2021","unstructured":"Yule S, Wanik J, Holm EM, Bruder MB, Shanley E, Sherman CQ, et al. Nutritional Deficiency Disease secondary to ARFID symptoms Associated with Autism and the broad autism phenotype: a qualitative systematic review of Case reports and Case Series. J Acad Nutr Diet. 2021;121(3):467\u201392.","journal-title":"J Acad Nutr Diet"},{"issue":"2","key":"1042_CR12","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1097\/WNO.0000000000000333","volume":"36","author":"Y Rapoport","year":"2016","unstructured":"Rapoport Y, Lavin PJ. Nutritional Optic Neuropathy caused by Copper Deficiency after bariatric surgery. 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This can be viewed from the journal editor.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests. No funding was required for this case report.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"90"}}