Key Takeaways

✅ Hematological abnormalities are commonly seen in patients with anorexia nervosa including:

• Anemia
• Leukopenia
• Thrombocytopenia
• Bone marrow changes:
  • Atrophy
  • Hypocellularity
  • Gelatinous transformation 

✅ Anemia occurs in about 1/3 of patients, is typically normocytic and normochromic and not associated with deficiencies in vitamin B12, folate or iron.

✅ Leukopenia occurs in about 1/3 of patients and is typically characterized by lymphocytopenia and/or neutropenia.

✅ Thrombocytopenia occurs in about 5 to 11% of patients.

✅ Hematological abnormalities:

• May be accentuated during first week of refeeding.
• Ultimately resolve with refeeding after a variable length of time.

✅ Cytopenias in patients with anorexia nervosa believed to be mediated by changes in the bone marrow including marrow hypoplasia, aplasia and gelatinous degeneration of bone marrow. 

✅ Because of the reversible nature of hematological changes with refeeding, there is generally no specific treatment required for the cytopenias beyond supportive care with blood transfusion.