Lapinskaitė A, Voiniušytė A, Valiulis T, Valantiejienė G, Lesinskienė S. Early-onset anorexia nervosa in prepubertal male twin: A case report. World J Clin Cases 2026; 14(16): 120211 [DOI: 10.12998/wjcc.v14.i16.120211]
Corresponding Author of This Article
Sigita Lesinskienė, MD, PhD, Full Professor, Clinic of Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, M. K. Čiurlionio g. 21, Vilnius LT-03101, Vilniaus Miestas, Lithuania. sigita.lesinskiene@mf.vu.lt
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Psychiatry
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Case Report
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Lapinskaitė A, Voiniušytė A, Valiulis T, Valantiejienė G, Lesinskienė S. Early-onset anorexia nervosa in prepubertal male twin: A case report. World J Clin Cases 2026; 14(16): 120211 [DOI: 10.12998/wjcc.v14.i16.120211]
Early-onset anorexia nervosa in prepubertal male twin: A case report
Augustė Lapinskaitė, Austėja Voiniušytė, Tadas Valiulis, Goda Valantiejienė, Sigita Lesinskienė
Augustė Lapinskaitė, Austėja Voiniušytė, Goda Valantiejienė, Sigita Lesinskienė, Clinic of Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius LT-03101, Vilniaus Miestas, Lithuania
Tadas Valiulis, Faculty of Medicine, Vilnius University, Vilnius LT-03101, Vilniaus Miestas, Lithuania
Co-first authors: Augustė Lapinskaitė and Austėja Voiniušytė.
Author contributions: Lesinskienė S conceived the case report; Voiniušytė A and Lapinskaitė A collected the clinical data; Voiniušytė A, Lapinskaitė A, and Valiulis T contributed to the drafting and preparation of the manuscript; Valantiejienė G and Lesinskienė S contributed to clinical supervision and critically revised the manuscript for important intellectual content; and all authors approved the final version of the manuscript.
AI contribution statement: As mentioned in AI contribution statement before, an AI-based tool Grammarly was used solely for language editing. It assisted in refining grammar and spelling but did not contribute to the scientific content, interpretation, or structure of the manuscript. The content, clinical interpretation, and conclusions are based entirely on the authors’ original work and clinical experience.
Informed consent statement: Informed consent was obtained from the patient’s guardians for publication of this case report.
Conflict-of-interest statement: All the authors declare that there are no conflicts of interest regarding the publication of this case report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Sigita Lesinskienė, MD, PhD, Full Professor, Clinic of Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, M. K. Čiurlionio g. 21, Vilnius LT-03101, Vilniaus Miestas, Lithuania. sigita.lesinskiene@mf.vu.lt
Received: February 24, 2026 Revised: March 31, 2026 Accepted: April 20, 2026 Published online: June 6, 2026 Processing time: 92 Days and 8.8 Hours
Abstract
BACKGROUND
Early-onset anorexia nervosa (EOAN), defined by onset before 14 years of age, represents a severe and complex subtype of anorexia nervosa (AN). It is characterized by persistent restriction of energy intake, significantly low body weight relative to age and height, intense fear of weight gain, and disturbed body image. Given that AN carries the highest mortality rate among psychiatric disorders, early recognition and prompt initiation of treatment are crucial, particularly in prepubertal children.
CASE SUMMARY
We describe a rare case of a 10-year-old prepubertal male twin admitted for inpatient psychiatric treatment following a 7-month history of progressive dietary restriction, marked weight loss, fear of weight gain, repetitive self-injurious abdominal behaviors, and disturbed body image. Comprehensive psychiatric assessment, psychological testing, and clinical observation led to a diagnosis of AN. Treatment included structured nutritional rehabilitation, restriction of physical activity, psychotherapy with active family involvement, and pharmacotherapy with sertraline (titrated to 100 mg/day) and olanzapine (titrated to 5 mg/day). During a 4-week hospitalization, the patient showed a reduction in obsessive preoccupations related to body shape and food restriction, with early signs of weight restoration.
CONCLUSION
This case highlights that AN can present with severe psychopathology in prepubertal children and poses a serious challenge to medical professionals, underscoring the importance of early recognition and intensive, multidisciplinary inpatient treatment, including psychosocial interventions with active family involvement, to achieve meaningful clinical improvement.
Core Tip: Early-onset anorexia nervosa (EOAN), defined as onset before 14 years of age, is a rare but clinically significant condition that may present in prepubertal boys and remains underrecognized. This case report describes EOAN in a 10-year-old male twin with rapid weight loss and self-injurious behaviors, emphasizing that anorexia nervosa can manifest with significant psychopathology before adolescence. The case highlights the critical importance of early recognition and prompt implementation of intensive, multidisciplinary, family-centered treatment to mitigate long-term physical and developmental consequences.
