Anorexia nervosa--a difficult diagnosis in boys. Illustrated by three cases.

The three patients described here have all been seen recently at the 
Royal Hospital for Sick Children in Edinburgh, and each has presented 
a diagnostic problem. In the three cases presented it has been 
difficult to establish the true diagnosis. In the first case, symptoms 
compatible with the diagnostic criteria of Beumont and his colleagues were 
directly the result of a slow-growing cerebral neoplasm which was elusive 
to diagnose. The second patient, a boy with cystic fibrosis, showed 
symptoms strongly suggestive of anorexia nervosa and responded to dietary measures 
without pancreatic enzyme replacement. We have been unable to demonstrate any 
organic disease in the third case and, hence, a presumptive diagnosis 
of anorexia nervosa has been made. It remains to be said 
that this condition is extremely rare in boys and that anorexia 
with weight loss warrants extremely thorough investigation. 