Biochemical and ultrasonic abnormalities of the pancreas in anorexia nervosa

Abstract

Seven of 10 patients with anorexia nervosa had ultrasonic and/or biochemical abnormalities of the pancreas. Seven patients had elevated amylase creatinine clearance ratios (greater than 4%), three patients had elevated serum amylase values (greater than 90 units/liter), and three patients had reduced echogenicity of the pancreas. There was no consistent association between presenting abdominal symptoms and abnormal ultrasonic and biochemical studies of the pancreas. After nutritional repletion, all studies reverted to normal. An eleventh patient, who was initially diagnosed as having anorexia nervosa but later found to have an astrocytoma of the medulla, had reduced echogenicity of the pancreas, suggesting malnutrition as the cause of these abnormal pancreatic studies. Pancreatic abnormalities due to protein-calorie malnutrition may be common in anorexia nervosa and must be differentiated from primary pancreatitis.

Hyperamylasemia and bulimia: A clinical review

“…Hyperamylasemia has been reported associated in patients who have anorexia nervosa as well as bulimia. In three reports (Nordgren & von Scheele, 1977;Gryboski, Hillemeier, Kocoshis, Anyan, & Seashore, 1980;Cox, Cannon, Ament, Phillips, & Schaffer, 1981) the hyperamylasemia was reported in patients with the bulimic form of anorexia nervosa, and all three reports inferred this as evidence of pancreatitis. As well, episodic binge eating, even in normals, has been known to cause acute pancreatitis (Jones, Gummer, & Lennard-Jones, 1968).…”

Oral and dental characteristics in bulimic and anorectic patients

“…It is likely that the parotid gland enlargement is sialoadenosis, a diagnosis applied to diffuse, asymptomatic, noninflammatory salivary gland enlargement (Schwartz & Friedman, 1973;Rand & Garlin, 1970). Sialoadenosis Oral Characteristics 429 has been described in associations with a number of endocrine and metabolic disorders, including various states of nutritional deficiency (Levin, 1980;Plessis, 1956;Walsh et al, 1981;Davidson, Leibl, & Berris 1969;Cummings, Schall, & Asofsky, 1971). In addition, we found elevated serum amylase activities in patients with eating disorders.…”

“…Only one anorectic patient had elevated amylase, pancreatic isoenzyme, and lipase activity resembling the pattern of a pancreatic affection. Hyperamylasemia has been reported in patients with anorexia nervosa as well as bulimia (Cox, Cannon, Ament, Phillips, & Schaffer 1981;Gryboski, Hillemeier, Kocoshis, Anyan, & Seashore 198;Kaplan, 1987;Gwirtsman, Yager, Gillard, & Lerner, 1986;Levin et al, 1980). Several authors believe that hyperamylasemia in patients with the bulimic form of anorexia derives from pancreas affections.…”

Computed tomographic abnormalities of the pancreas in eating disorders: A report of two cases with normal laparotomy

“…Reversible biochemical and ultrasonic abnormalities have been described in patients with anorexia nervosa (Cox et al, 1983;Nordgren & Von Scheele, 1977;Mitchell & Pyle, 1982), but CT scan aberrations have not previously been reported. The pathological counterpart for this remains unknown, since laparotomy in both patients failed to reveal any obvious macroscopic abnormality, and histological assessment of the pancreas in case 1 was normal.…”