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Anorexia Nervosa: Russell's Sign with Concurrent Tetany

Adapted from Article by Young J, Henderson M, Thompson G

A 32-year-old female with a history of binge-purge type anorexia nervosa presented with abdominal pain and weight loss of 8 kg over the preceding 2 weeks. She denied prior diuretic or laxative abuse. Physical examination showed a thin female with a BMI of 14.2 kg/m2. The dorsal aspect of her hands revealed abrasions, callosities, and scarring.

Her hands were contracted in tetany, flexed at the metacarpophalangeal joints, with extension at the interphalangeal joints with the thumb flexed and adducted.

Laboratory studies revealed a serum calcium of 5.3 mg/dl, albumin of 3.0 g/dl, and normal serum 25-hydroxyvitamin D and parathyroid hormone levels.

This case is adapted from the following article:
Anorexia Nervosa: Russell's Sign with Concurrent Tetany; Young J, Henderson M, Thompson G; JGIM 2011, June; 26(6):668 
This article is available on PubMed Central