1. Mehler PS, Crowe S. Medical Complications of Anorexia Nervosa in Mitchell J. Gillo M. Eating Disorders Hand Book. 59-71, 2010.

ABSTRACT: Two females with severe anorexia nervosa (BMI of 10) were seen with marked abnormalities in their liver function tests before the initiation of refeeding. These paradoxically resolved with progressive refeeding and weight restoration. Clinical observation during regimented medical stabilization and refeeding of two patients with severe anorexia nervosa with frequent monitoring of liver function tests. Normalization of liver function tests ensued as caloric intake increased and weight gain progressed.

ABSTRACT: Anemia, leukopenia and thrombocytopenia are frequent complications of anorexia nervosa. The complete blood count provides useful information to diagnose and characterize these findings. Anemia tends to be normocytic and normochromic. Leukopenia manifests as a deficiency of lymphocytes or neutrophils. Thrombocytopenia, if severe, may confer a bleeding risk. A careful history and physical examination should be performed to evaluate for other possible etiologies of cytopenias.

Complement Activation in Severe Anorexia Nervosa: A Prospective Cohort Study.

Flierl MA, Gaudiani JL, Sabel A, Long CS, Stahel PF, Mehler PS. 'Complement Activation in Severe Anorexia Nervosa: A Prospective Cohort Study.' Eating Disorders Research Society, 2010.

ABSTRACT: Of the many body systems adversely affected by severe anorexia nervosa (AN), the pulmonary system is relatively spared. However, in the face of severe malnutrition of AN, the lung may undergo architectural changes that adversely affect its integrity and healing capacity. We report herein a case of a pneumothorax in a patient with severe AN, in which standard approaches to manage the pneumothorax were unsuccessful.

ABSTRACT: To systematically review the evidence supporting treatment of osteopenia and osteoporosis in patients with anorexia nervosa (AN). We identified controlled clinical studies of interventions for low bone mass in AN via searches of MEDLINE; the Cochrane Library; EMBASE; PsycINFO; and cumulative index to nursing and allied health literature.

ABSTRACT: Weight restoration is crucial for successful treatment of anorexia nervosa. Without it, patients may face serious or even fatal medical complications of severe starvation. However, the process of nutritional rehabilitation can also be risky to the patient. The refeeding syndrome, a problem of electrolyte and fluid shifts, can cause permanent disability or even death.

Anorexia nervosa is a difficult disease to treat effectively. Inpatient treatment in facilities with specialized expertise heightens the chance for success. Patients with the most severe degrees of anorexia nervosa are especially in need of hospitalization.

ABSTRACT: Anorexia nervosa is a challenging disorder to treat, both from a medical and a psychiatric standpoint. Part of the clinical difficulty is based on the patient's ardent desire to resist meaningful weight restoration, and the debilitating fear of food which defines this disorder. However, there are also litanies of medical complications which can interfere with the refeeding process and which affect many different body systems. One particularly concerning sequela of this refeeding is known as the refeeding syndrome.

Abstract