Successful management of gelatinous transformation of the bone marrow in anorexia nervosa with hematopoietic growth factors

• Published in: The International journal of eating disorders 2011-07, Vol.44 (5), p.469-472
• Main Authors: Charania, Roseleen S., Kern, William F., Charkrabarty, Shouvik, Holter, Jennifer
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Anorexia; Anorexia nervosa; Anorexia Nervosa - blood; Anorexia Nervosa - complications; Anorexia Nervosa - pathology; Biological and medical sciences; Blood diseases; Bone marrow; Bone Marrow - metabolism; Bone Marrow - pathology; Bone Marrow Diseases - drug therapy; Bone Marrow Diseases - etiology; Bone Marrow Diseases - pathology; Darbepoetin alfa; Disease management; Eating behavior disorders; Eating disorders; Erythropoietin - analogs & derivatives; Erythropoietin - therapeutic use; Female; Filgrastim; gelatinous transformation; Granulocyte Colony-Stimulating Factor - therapeutic use; Hematinics - therapeutic use; Hematologic and hematopoietic diseases; Hematopoietic Cell Growth Factors - therapeutic use; Humans; Medical sciences; Other diseases. Hematologic involvement in other diseases; pancytopenia; Pancytopenia - drug therapy; Pancytopenia - etiology; Pancytopenia - pathology; Polyethylene Glycols; Proteins; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Recombinant Proteins; serous atrophy; Treatment Outcome
• ISSN: 0276-3478; 1098-108X
• DOI: 10.1002/eat.20833

Serous atrophy or gelatinous transformation of the bone marrow (GMT), often seen with severe nutritional deprivation in Anorexia Nervosa (AN), is characterized by hypocellularity and patchy or diffuse replacement of the bone marrow with hyaluronic acid‐like mucopolysaccharide material. Treatment with nutritional support alone is often temporary due to the relapsing nature of AN. We present the case of a patient with pancytopenia due to GMT who had multiple prior hospitalizations for infections and blood transfusions. Nutritional support was inadequate in restoring her bone marrow function. She was successfully treated with hematopoietic growth factors and achieved a sustained hematopoietic recovery. In addition, use of growth factors resulted in a 91% reduction in the cost of health care delivered to this patient. Int J Eat Disord 2010. © 2010 by Wiley Periodicals, Inc.