Anorexia Nervosa: Complications

CARDIAC ABNORMALITIES

 - Functional: Low BP, Sinus bradycardia, prolonged QT interval

 - Structural: Reduced cardiac muscle mass

GASTROINTESTINAL FINDINGS

 - Gastroparesis and Constipation

 - Elevated Hepatic Enzymes - From fasting/weight loss

RENAL FINDINGS 

 - Dehydration -> GFR leads to BUN -> Significant Hypotension/ Hypovolemia

NEUROLOGIC FINDINGS

 - Cerebral Atrophy and Metabolic Encephalopathy from significant fluid and electrolyte disturbances -> Difficulty concentrating and memory loss

HEMATOLOGIC FINDINGS

 - Leukopenia with lymphocytosis, mild anemia and thrombocytopenia

ENDOCRINE ABNORMALITIES

 - Hypogonadotrophic hypogonadism - acquired from nutrient deficiency and hormone suppression

 - Low-Normal T3/T4

 - Females: Low Serum Estrogen

 - Males: Low Serum Testosterone

 - Delay of puberty/menarche

 - Amenorrhea - (loss of menses)

 - Osteopenia/Osteoporosis

 - Low bone mineral density, Significantly increased risk of fracture

DERMATOLOGIC PRESENTATIONS

 - Dry skin, brittle nails, hair loss, hypercarotenemia (yellowing of skin)

 - Lanugo: fine downy hair covering limbs and cheeks (to preserve warmth)

GENERAL FEATURES:

 - Emaciation: loss of body fat and muscle

 - Hypothermia and Cold Intolerance

 - Lethargy or Excess Energy

Death - Cardiac complications, starvation, electrolyte imbalance

 • Note: Anorexia nervosa has one of the highest mortality rates of all psychiatric illnesses

 • Suicide risk is increased in anorexia, especially the binge-purge subtype



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