title: The paradox of normal serum albumin in anorexia nervosa: a case report.
abstract: OBJECTIVE
  Anorexia nervosa (AN) is associated with marked decreases in caloric intake and a corresponding reduction in body weight due to abnormal self body image. Although counterintuitive, hypoalbuminemia and vitamin deficiencies are not expected consequences of this disorder. Etiologic considerations for hypoalbuminemia are discussed.
  
  
  METHODS
  The case report of a patient with AN and marked hypoalbuminemia is presented and a focused literature review is reported.
  
  
  RESULTS
  Hypoalbuminemia was initially attributed to starvation. However, occult infection was ultimately responsible. Serum albumin concentration normalized with antibiotic therapy despite minimal restoration of body weight.
  
  
  CONCLUSIONS
  Hypoalbuminemia should not be considered a characteristic feature of AN even in the setting of progressive weight loss. The presence of other potentially life-threatening conditions should be sought, as reduced serum albumin concentration is a marker of inflammation in AN.
authors.affiliation: Department of Internal Medicine, Denver Health Medical Center, Denver, Colorado, USA.
authors.forename: Mori J
authors.initials: MJ
authors.lastname: Krantz
authors.forename: David
authors.initials: D
authors.lastname: Lee
authors.forename: William T
authors.initials: WT
authors.lastname: Donahoo
authors.forename: Philip S
authors.initials: PS
authors.lastname: Mehler
mesh_terms: D000856:Anorexia Nervosa / Q000097:blood* / Q000150:complications; D005260:Female; D006801:Humans; D034141:Hypoalbuminemia / Q000209:etiology*; D007239:Infections / Q000150:complications / Q000175:diagnosis*; D008875:Middle Aged