ECE2016 Eposter Presentations Bone & Osteoporosis (40 abstracts)
Anorexia nervosa: beyond psychiatry
Nuno Vicente 1 , Dírceaj Rodrigues 1 , Luísa Barros 1 , Daniela Guelho 1 , Luís Cardoso 1 , Diana Martins 1 , Diana Oliveira 1 , Adriana Lages 1 , Mara Ventura 1 , Lígia Fonseca 2 , Júlia Figueiredo 3 & Francisco Carrilho 1
1Endocrinology, Diabetes and Metabolism Department, Coimbra, Portugal; 2Psychiatry Department, Coimbra, Portugal; 3Nutrition Unit, Coimbra, Portugal.
Introduction: Despite being a psychiatric disorder, anorexia nervosa (AN) is associated to severe systemic complications. The endocrine complications of AN are an opportunity for the diagnosis and treatment of this condition. The authors report the experience of the Endocrinology Department in the treatment of AN in inpatient setting.
Patients and methods: Retrospective analysis of 45 patients admitted with AN between 2001 and 2015 in the Endocrinology department, corresponding to 63 admissions. During admission, patients had daily multidisciplanary monitoring, including endocrinology, psychology, nutrition and nursing, with support from psychiatry whenever needed. Clinical and analytical parameters, as well as other exams (electrocardiogram and bone densitometry) were performed immediately after admission.
Results: Most patients were female (93.3%; n=42), with mean age 20.6±7.7 years. Restrictive subtype in 86.7% (n=39), with the remainder of the purgative type. On admission, mean BMI 14.3±1.6 kg/m2 and percentage of fat mass 4.2±2.4%. Amenorrhea was present in 48.9% (n=22), euthyroid sick syndrome in 15.6% (n=7), hypogonadotrophic hypogonadism in 51.1% (n=23), anemia in 33.3% (n=15) and leukopenia in 37.8% (n=17). Sinus bradicardia was the most common electrocardiographic finding (22.2%, n=10). Bone densitometry documented osteopenia and osteoporosis in 57.1 and 31%, respectively. Admissions had a mean lenght of stay of 44±20 days, and patients had a mean increase in BMI of 1.7±2.3 kg/m2. Readmission was needed in 35.6% of cases (n=16), due to failure to increase weight.
Conclusion: The main indication for admission was the low weight. The most frequent endocrine complications were low bone mass (88.1%), hypogonadotrophic hypogonadism (51.1%) and euthyroid sick syndrome (15.6%). Although prolonged, hospitalization was useful, with improvement in clinical and analytical parameters. These patients need a careful monitoring due to the substantial risk of relapse.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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