title: Successful management of gelatinous transformation of the bone marrow in anorexia nervosa with hematopoietic growth factors.
abstract: Serous atrophy or gelatinous transformation of the bone marrow (GMT), often seen with severe nutritional deprivation in Anorexia Nervosa (AN), is characterized by hypocellularity and patchy or diffuse replacement of the bone marrow with hyaluronic acid-like mucopolysaccharide material. Treatment with nutritional support alone is often temporary due to the relapsing nature of AN. We present the case of a patient with pancytopenia due to GMT who had multiple prior hospitalizations for infections and blood transfusions. Nutritional support was inadequate in restoring her bone marrow function. She was successfully treated with hematopoietic growth factors and achieved a sustained hematopoietic recovery. In addition, use of growth factors resulted in a 91% reduction in the cost of health care delivered to this patient.
authors.affiliation: Department of Oklahoma Hematology and Oncology, University of Oklahoma Health Sciences Center, Oklahoma, USA. rcharani@ouhsc.edu
authors.forename: Roseleen S
authors.initials: RS
authors.lastname: Charania
authors.forename: William F
authors.initials: WF
authors.lastname: Kern
authors.forename: Shouvik
authors.initials: S
authors.lastname: Charkrabarty
authors.forename: Jennifer
authors.initials: J
authors.lastname: Holter
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000097:blood / Q000150:complications* / Q000473:pathology; D001853:Bone Marrow / Q000378:metabolism / Q000473:pathology; D001855:Bone Marrow Diseases / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D000068256:Darbepoetin alfa; D004921:Erythropoietin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006397:Hematinics / Q000627:therapeutic use*; D016298:Hematopoietic Cell Growth Factors / Q000627:therapeutic use*; D006801:Humans; D010198:Pancytopenia / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D011092:Polyethylene Glycols; D011994:Recombinant Proteins; D016896:Treatment Outcome
chemical_list: D006397:Hematinics; D016298:Hematopoietic Cell Growth Factors; D011994:Recombinant Proteins; D004921:Erythropoietin; D016179:Granulocyte Colony-Stimulating Factor; D000068256:Darbepoetin alfa; C455861:pegfilgrastim; D011092:Polyethylene Glycols; D000069585:Filgrastim