title: Hematological complications in anorexia nervosa.
abstract: Anemia, leukopenia and, although less frequently, thrombocytopenia are possible hematological complications of anorexia nervosa considered strictly secondary to chronic malnutrition. This is a retrospective study on the prevalence of these disorders in a large cohort of 318 female patients with AN (20.4±5.6 years, body mass index (BMI) 15.9±1.6 kg/m2), recruited in the Outpatient Unit for Malnutrition secondary to Eating Disorders at the Department of Clinical Medicine and Surgery, Federico II University Hospital, since February 1991 to December 2012.
  
  
  
  Patients were studied on an outpatient basis after obtaining medical history, clinical examination, routine hematobiochemical and endocrine tests, electrocardiography, psychiatric interview and bioelectrical impedance analysis and, in particular, phase angle determination. All patients with other comorbidities, in particular with mean corpuscular volume <80 fl, were excluded for suspected genetic alteration in the synthesis of hemoglobin.
  
  
  
  Hematologic data showed that 16.7% of patients had anemia, 7.9% neutropenia and 8.9% thrombocytopenia. These abnormalities were strictly related to the duration of illness (P=0.028), and to protein energy malnutrition, in particular, BMI and phase angle (P<0.001).
  
  
  
  Our study offers description of the incidence of hematologic defects in a selected and large sample of AN female patients, suggesting that its incidence is related to the degree and duration of protein energy malnutrition.
authors.affiliation: Department of Clinical Medicine and Surgery 'Federico II' University, Naples, Italy.
authors.forename: E
authors.initials: E
authors.lastname: De Filippo
authors.affiliation: Department of Clinical Medicine and Surgery 'Federico II' University, Naples, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Marra
authors.affiliation: Department of Clinical Medicine and Surgery 'Federico II' University, Naples, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Alfinito
authors.affiliation: Department of Clinical Medicine and Surgery 'Federico II' University, Naples, Italy.
authors.forename: M L
authors.initials: ML
authors.lastname: Di Guglielmo
authors.affiliation: Department of Clinical Medicine and Surgery 'Federico II' University, Naples, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Majorano
authors.affiliation: Department of Clinical Medicine and Surgery 'Federico II' University, Naples, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Cerciello
authors.affiliation: Department of Clinical Medicine and Surgery 'Federico II' University, Naples, Italy.
authors.forename: C
authors.initials: C
authors.lastname: De Caprio
authors.affiliation: Interuniversity Center for Obesity and Eating Disorders, Medical School, 'Federico II' University, Naples, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Contaldo
authors.affiliation: Interuniversity Center for Obesity and Eating Disorders, Medical School, 'Federico II' University, Naples, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Pasanisi
mesh_terms: D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000097:blood / Q000150:complications*; D002648:Child; D015331:Cohort Studies; D004044:Dietary Proteins; D005260:Female; D006402:Hematologic Diseases / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D004044:Dietary Proteins