Bone marrow hypoplasia in anorexia nervosa.

Within a 2-year period, from March 1974 until May 1976 10 patients with anorexia nervosa were seen at the children's university hospitals of München (2 patients) and Giessen (8 patients). The patients were 10-16 years old, with one exception all girls, and had the typical cachexia, hypothermia, bradycardia, gray, hairy skin, and amenorrhea in those who had reached menarche. The blood counts at diagnosis revealed a leukopenia (below 5000/mm3) in 6 patients and a thrombocytopenia (below 150000/mm3) in 4 patients. The bone marrow was examined in 7 patients and showed marked hypocellularity with only few megakaryocytes present and abundant vacuolated hyaline material. Bone marrow erythroblasts were decreased (below 20%) in 5 patients, although peripheral blood hemoglobin and hematocrit were normal or even elevated in all 10 patients. In 7 patients blood urea nitrogen was elevated above 30 mg%, the highest value being 145 mg%. Blood and bone marrow alterations as well as the renal abnormalities disappeared within days to a few weeks after a regimen of strict fluid and caloric intake was initiated and a gain in body weight of up to 10 kg was achieved.