An 18-Year-Old Woman Presented to the Office Due to Left

An 18-year-old woman presented to the office due to left arm pain after a fall. The patient fell on her arm, while she was working out at the gym where she uses to exercise regularly. The patient has no prior medical or surgical history. She uses several diets for weight loss, and she is now on a vegan diet. Her last menstrual period was 4 months ago. She does not use tobacco, alcohol, or illicit drugs. Temperature is 36.1 C (97 F) , blood pressure is 92/60 mm Hg, and pulse is 53/min. BMI is 18.1 kg/m2. Weight is 51.7 kg (110.2 lb) and height is 169 cm. Physical examination shows tenderness in the left arm. There is parotid enlargement with fine hair widespread over the extremities. A urine pregnancy test is negative. X-rays reveal a nondisplaced fracture of the left humerus and generalized radiolucency of the bone. Which of the following is the most likely diagnosis?

A) Anorexia nervosa
B) Avoidant/restrictive food intake disorder
C) Bulimia nervosa
D) Pellagra
E) Rickets
F) Scurvy