The death of Charlotte Brontë from hyperemesis gravidarum and refeeding syndrome: A new perspective

Abstract

Many theories have been advanced concerning the cause of Charlotte Brontë's death, none of which fully explain all the symptoms she experienced in the course of her final illness. Her death certificate records the cause of death as phthisis (tuberculosis), but there is no evidence, other than circumstantial, to support this diagnosis. A diagnosis of Addison's disease, caused by tuberculosis of the adrenals, has been proposed, but this is unlikely, since it does not fit well with two and a half months of severe anorexia, nausea and vomiting, followed by remission of these symptoms and eventual death. We agree, as suggested by some authors, that the most likely diagnosis was hyperemesis gravidarum, but suggest that this was complicated by the refeeding syndrome consequent on recovery of her appetite after resolution of hyperemesis gravidarum and that this was the cause of her death. These two diagnoses are compatible with the remission in her symptoms of anorexia, nausea and vomiting in the third week of March 1855, followed by further decline and death.

Keywords: Appetite; Cause of death; Charlotte Brontë; Hyperemesis gravidarum; Refeeding syndrome.