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Originalarbeiten/Original articles

Hämatologische Veränderungen bei Anorexia nervosa im Kindes- und Jugendalter

Published Online:December 23, 2013https://doi.org/10.1024/1422-4917/a000266

Abstract

Fragestellung: Hämatologische Veränderungen sind ein häufiges Phänomen der akuten Anorexia nervosa (AN). Dennoch ist der Zusammenhang mit klinischen Parametern noch unzureichend untersucht. Methodik: Bei 88 Patientinnen mit AN nach DSM-IV wurden bei stationärer Aufnahme und nach Gewichtsrehabilitation die Konzentration der Leukozyten, Erythrozyten und Thrombozyten, der Hämoglobingehalt, der Hämatokrit und ein Differenzialblutbild bestimmt und ein Zusammenhang mit verschiedenen klinischen Parametern untersucht. Ergebnisse: Bei Aufnahme zeigten sich milde Veränderungen der Blutwerte, die zumeist mit der Gewichtsrehabilitation reversibel waren. Patientinnen mit einem großen Gewichtsverlust vor Aufnahme und einem niedrigen altersadjustierten BMI sowie diejenigen, die Psychopharmaka einnahmen, hatten ein größeres Risiko, hämatologische Veränderungen aufzuweisen. Schlussfolgerungen: Auch wenn die hämatologischen Veränderungen bei jugendlichen Patientinnen mit AN zumeist milde sind, sollte bei Patientinnen mit niedrigem altersadjustiertem BMI und/oder ausgeprägter Gewichtsabnahme oder begleitenden Psychopharmakotherapie, auf ein sorgfältiges Monitoring des Blutbildes geachtet werden. Eine Veränderung der leukozytenabhängigen Immunantwort scheint bei erwachsenen chronifizierten Patientinnen zu einer gesteigerten Infektionsgefahr und damit einer erhöhten Mortalität beizutragen.


Hematological changes in adolescent anorexia nervosa

Objective: Hematological changes often occur in patients with acute anorexia nervosa (AN). However, the relationship between these disturbances and other clinical parameters remains unclear. Method: Leucocyte, erythrocyte, and thrombocyte counts as well as hematocrit, hemoglobin, and differential blood counts were collected at admission and after weight restoration in 88 female adolescent patients with the diagnosis of AN according to DSM-IV. These were then compared to clinical parameters. Results: At admission, there were mild changes in the blood count, most of which, however, were reversible after weight gain. Patients with a greater weight loss, a lower age-adjusted BMI, and a history of taking psychotropic drugs were more likely to develop hematological abnormalities. Conclusions: Although most of the hematological changes in adolescent patients with AN were mild, patients with high weight loss and/or low age-adjusted BMI as well as those on psychotropic medication should be monitored carefully in order to avoid severe medical complications. An altered immune function in adult patients with chronic AN might contribute to a higher rate of infections and thus to an increased mortality.

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