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Anorexia May Cause Emphysema, Study Suggests

Malnutrition resulting from anorexia nervosa has been known to cause many medical complications.  Now, research presented at the 2003 Annual Meeting of the Radiological Society of North America (RSNA), has found that anorexia may cause emphysema as well.

Researchers used a new method of assessing computed tomography (CT) scans to analyze the lungs of anorexic patients and found that malnutrition changes the physical structure of the lung. "There is a reduction in the amount of lung tissue in patients with anorexia nervosa," said Harvey O. Coxson, Ph.D., lead author of the study from Vancouver General Hospital (VGH) in Canada.   "It is unclear whether these structural changes are permanent," he said, "but if they are, early therapy is important in patients who have anorexia."

Anorexia nervosa, which primarily affects young women, is an eating disorder characterized by voluntary starvation. The National Institute of Mental Health reports that between 0.5 and 3.7 percent of female Americans will suffer from anorexia during their lifetime. Eighty-six percent of patients report disease onset before age 20. In severe cases, the lack of nourishment to the body can result in serious heart, kidney and liver damage.

For this study, Dr. Coxson and colleagues compared CT findings from 14 patients diagnosed with anorexia nervosa and 16 control patients. None of the patients had a family history of lung disease. In addition to providing detailed images, CT measured the absorbance of x-rays within the lung. The x-ray absorbance values were then converted to measurements of lung structure and were compared to clinical factors, such as body mass index and results of breathing tests.

The findings indicated that the lung structure of the anorexic patients differed from that of the control patients, with a loss of some of the tissue that helps deliver oxygen to the rest of the body. Similar changes are evident in patients with emphysema caused by cigarette smoking, and produce shortness of breath and other respiratory problems.

Previously published animal studies have suggested a correlation between malnutrition and emphysema. But until the advent of CT, the diagnosis of emphysema relied on the pathologic examination of lung tissue. According to Dr. Coxson, a study conducted by Jewish physicians in the Warsaw Ghetto during the Nazi occupation showed that 13.8 percent of people who died of starvation had emphysema at autopsy and 68 percent of those were under the age of 50. A much higher rate of emphysema than would be expected in people under the age of 50, this was the first evidence linking emphysema to malnutrition.

Created: 1/21/2004  -  Donnica Moore, M.D.

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