N Ibrahim1, A Barruchet1, M R Moro1,2,3, C Blanchet4,5,6. 1. APHP, Cochin Hospital, Maison de Solenn, 75014, Paris, France. 2. University of Paris, PCPP, 92100, Boulogne-Billancourt, France. 3. University of Paris-Saclay-UVSQ, INSERM, CESP, Team DevPsy, 94805, Villejuif, France. 4. APHP, Cochin Hospital, Maison de Solenn, 75014, Paris, France. corinne.blanchet@aphp.fr. 5. University of Paris, PCPP, 92100, Boulogne-Billancourt, France. corinne.blanchet@aphp.fr. 6. University of Paris-Saclay-UVSQ, INSERM, CESP, Team DevPsy, 94805, Villejuif, France. corinne.blanchet@aphp.fr.
Abstract
PURPOSE: We describe a case of severe, prolonged neutropenia in an adolescent girl hospitalized for anorexia nervosa (AN) which occurred during a refeeding procedure in the absence of refeeding syndrome. METHODS: This case report includes retrospective anamnestic, clinical and biological data from the patient's medical record. A literature review was conducted on the haematological changes described in the undernutrition and refeeding periods, and also on recent data for underfeeding syndrome in patients with anorexia nervosa. CONCLUSION: Leuconeutropenia is an adaptive condition observed in undernutrition in AN, usually rapidly and completely reversible in the course of refeeding and weight gain. We describe a rare case of severe, prolonged neutropenia despite appropriate care in the absence of refeeding syndrome and without gelatinous bone marrow transformation. We suggest that neutropenia in adolescent anorexia nervosa could be a stigma of underfeeding syndrome resulting from an overly cautious refeeding strategy. LEVEL OF EVIDENCE: Level V, descriptive study.
PURPOSE: We describe a case of severe, prolonged neutropenia in an adolescent girl hospitalized for anorexia nervosa (AN) which occurred during a refeeding procedure in the absence of refeeding syndrome. METHODS: This case report includes retrospective anamnestic, clinical and biological data from the patient's medical record. A literature review was conducted on the haematological changes described in the undernutrition and refeeding periods, and also on recent data for underfeeding syndrome in patients with anorexia nervosa. CONCLUSION: Leuconeutropenia is an adaptive condition observed in undernutrition in AN, usually rapidly and completely reversible in the course of refeeding and weight gain. We describe a rare case of severe, prolonged neutropenia despite appropriate care in the absence of refeeding syndrome and without gelatinous bone marrow transformation. We suggest that neutropenia in adolescent anorexia nervosa could be a stigma of underfeeding syndrome resulting from an overly cautious refeeding strategy. LEVEL OF EVIDENCE: Level V, descriptive study.
Authors: E De Filippo; M Marra; F Alfinito; M L Di Guglielmo; P Majorano; G Cerciello; C De Caprio; F Contaldo; F Pasanisi Journal: Eur J Clin Nutr Date: 2016-07-20 Impact factor: 4.016