Case report: Reversal of severe leukopenia by granulocyte colony- stimulating factor in anorexia nervosa

S. Fukudo, A. Tanaka, M. Muranaka, M. Sasaki, S. Iwahashi, T. Nomura, A. Tashiro, A. Hoshino

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18 Citations (Scopus)

Abstract

Recent attempts to reduce weight by patients with anorexia nervosa have sometimes led to life-threatening hematologic complications. This report describes an instance in which a patient with anorexia nervosa and pancytopenia drastically improved with treatment that included administration of granulocyte colony-stimulating factor. The patient had lost 27 kg of body weight within 8 months. Even after admission, the blood cell count continued to decrease rapidly as follows: platelet, from 244 x 103/μl to 44 x 103/μl; erythrocyte, from 4.04 x 106/μl to 2.58 x 106/μl; and leukocyte, from 4.8 x 103/μl to 1.6 x 103/μl (granulocyte, 0.8 x 103/μl). Complications included pneumomediastinum, pneumothorax, purpura, petechiae, hepatomegaly, fever, gangrenous stomatitis, and somnolence. Bone marrow aspiration disclosed absence of fat cells, marrow hypoplasia, and infiltration of the mature lymphocytes. Intravenous hyperalimentation, blood transfusion, γ-globulin, and antibiotics were administered, but leukopenia and fever remained. However, administration of recombinant human granulocyte colony-stimulating factor dramatically reversed the leukopenia and fever. With careful nutrition therapy, the patient's blood cell count and bone marrow normalized by the time of discharge. It was concluded that severe hematologic disorders may occur in patients with anorexia nervosa, and advanced treatment may be required to save the patient's life.

Original languageEnglish
Pages (from-to)314-317
Number of pages4
JournalAmerican Journal of the Medical Sciences
Volume305
Issue number5
DOIs
Publication statusPublished - 1993

Keywords

  • Anorexia nervosa
  • Bone marrow hypoplasia
  • Granulocyte colony-stimulating factor
  • Leukopenia
  • Pancytopenia

ASJC Scopus subject areas

  • Medicine(all)

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