Mitochondrial Neurogastrointestinal Encephalopathy (MNGIE) disease in a Patient with Concern for an Eating Disorder

Case Presentation A 20 year-old female presented with one and a half years of worsening abdominal pain, weight loss of 13-kg, intermittent emesis, and alternating bouts of diarrhea and constipation. Prior admissions had led to a diagnosis of disordered eating. However, she denied restrictive and binge-eating behaviors, and reported a desire to gain weight, making anorexia nervosa unlikely. On exam, she was cachectic (BMI 12kg/m2) and tachycardic with a diffusely tender abdomen. Her workup was significant for microcytic anemia, elevated transaminases, hypoalbuminemia, lactic acidosis, and a positive …