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.

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