Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0013911 (emaciation)
 1,059 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

It is clinically well recognized that certain symptoms in anorexia nervosa such as motor hyperactivity, alert and animated mental disposition, and insufficient awareness of bodily changes are inconsistent with profound emaciation. This article discusses the metabolic, endocrine-hypothalamic, and neurotransmitter changes that occur in anorexia nervosa and explores the relationship of these changes to the development and maintenance of these symptoms.
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PMID:Hypothalamic dysfunction and symptoms of anorexia nervosa. 647 82

Hormonal investigations were performed in 8 cases of male anorexia nervosa at the time of their maximum emaciation. In 6 cases, these investigations were repeated during weight gain. At the time of the maximum emaciation, serum testosterone (T) was decreased in every case. Mean values of serum T, estradiol (E2), LH and FSH were significantly lower than those of controls with a comparable age and a normal weight. Four times out of five serum gonadotropins did not increase after LHRH injection. During weight gain, values of T, E2, LH, FSH and the gonadotropins' response to LHRH increased. T values and the corpulence index were significantly correlated (p less than 0,001), though these 2 parameters did not constantly change in a parallel way. Thus, male anorexia nervosa is associated with a severe hypogonadotropic hypogonadism. This hypogonadism results from weight loss, but also from other factors, especially psychosomatic ones.
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PMID:[Profile of gonadal hormones in 8 cases of male anorexia nervosa studied before and during weight gain]. 667 Aug 50

This article presents a psychodynamic approach to the understanding and treatment of abstaining and bulemic anorexics. While the abstainer starves herself to the point of emaciation and the bulemic may gorge to the point of obesity, the underlying emotional conflicts of the two groups of patients are the same. The ego (character structure) of the bulemic is not as perfectionistic and rigid as that of the abstainer, so the patient is periodically overwhelmed not only by impulses to gorge but also by impulses of all kinds. A description of the clinical syndrome, the physiological findings and details of the laboratory diagnosis of anorexia nervosa are provided. Family psychodynamics which are viewed as etiologic are presented. A psychodynamic therapeutic approach is described and examples of the treatment of an abstaining and bulemic patient are detailed. The crucial therapeutic role of the family physician is explored with emphasis on the importance of the physician's encouraging the patient to bring up questions about food and eating with the psychiatrist because such preoccupations mask other conflicts.
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PMID:Abstaining and bulemic anorexics. Two sides of the same coin. 695 65

This review presents 21 cases, found in the literature, of a CNS lesion (a tumor in 19 of them) associated with emaciation, anorexia and several psychic symptoms that had led to the diagnosis of anorexia nervosa (AN). Anorexia and psychic disturbances preceded the neurologic signs and/or the correct diagnosis in all patients (by a mean of 2.9 years, range = 0.2-17 years). Anorexia had begun before the age of 25 years in 18 patients of which two-thirds were females. Only a few cases fulfilled the DSM-III-R criteria for AN; the majority could be characterized as 'atypical AN'. Although AN is usually conceived as a primarily psychogenic disorder, structural lesions of the hypothalamus (or other sites involved in food regulation) in animal models and in these human cases mimic many features of AN, suggesting the possibility of an as yet unidentified structural hypothalamic disorder to be implicated in the etiopathogeny of AN. The unusually high incidence of germ-cell tumors in this review (33%) suggests that they are more likely than other tumors to influence the limbic system toward an anorectic syndrome.
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PMID:Brain tumors and anorexia nervosa syndrome. 794

A mixed retrospective-prospective study of 70 Chinese anorexic patients in Hong Kong shows that although they were similar to Western anorexics in most other ways, 41 (58.6%) of them did not exhibit any fear of fatness throughout their course of illness. Instead, these non-fat phobic patients used epigastric bloating (31.4%), no appetite/hunger (15.7%) or simply eating less (12.9%) as legitimating rationales for food refusal and emaciation. Compared to fat phobic anorexics, they were significantly slimmer pre-morbidly (P < 0.0001) and were less likely to exhibit bulimia (P = 0.001). The possible explanations for the absence of fat phobia and the interpretive dilemma this provokes are discussed from historical, pathoplastic and cultural anthropological perspectives. It is argued that anorexia nervosa may display phenomenological plurality in a Westernizing society, and its identity may be conceptualized without invoking the explanatory construct of fat phobia exclusively. As non-fat phobic anorexia nervosa displays no culturally peculiar features, it is not strictly speaking a Western culture-bound syndrome, but may evolve into its contemporary fat phobic vogue under the permeative impact of Westernization. Its careful evaluation may help clarify the aetiology and historical transformation of eating disorder, foster the development of a cross-culturally valid taxonomy of morbid states of self-starvation, and exemplify some of the crucial issues that need to be tackled in the cross-cultural study of mental disorders.
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PMID:Fat phobic and non-fat phobic anorexia nervosa: a comparative study of 70 Chinese patients in Hong Kong. 813 23

Psychosexual dysfunctioning is often put forward as an etiological factor in anorexia nervosa. In contrast, we hypothesize that anorexia nervosa patients were in general psychosexually normal before their illness, and that the problems in their sexual life arise only after the emergence of hypogonadism, as a consequence of emaciation. Our study shows that patients, before they became anorectic, were indeed rather similar to normal subjects with respect to sexual attitude. Moreover, patients reported a considerably decreased sexual interest during their anorectic period when compared with normal controls. We conclude that these results corroborate our hypotheses. In the discussion we sketch a theoretical account of the origin and course of anorexia nervosa, according to which the hormonal and associated psychosexual changes are central to its pathogenesis.
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PMID:The paradoxical nature of sexuality in anorexia nervosa. 830 13

We examined the nasopharynx and brain in 17 patients with anorexia nervosa by CT and compared the findings with those of 44 normal subjects and of 5 patients of the same age with marked emaciation caused by various psychiatric disorders. An enlarged nasopharyngeal space with a flattened posterior wall and enlarged lateral pharyngeal recesses were demonstrated in all patients with anorexia nervosa whose weight was lowest at the time of the CT examination, and these CT features regressed or became normal quickly after they had gained some weight. This characteristic enlargement of the nasopharynx and lateral pharyngeal recesses was observed neither in the markedly emaciated patients (2 with schizophrenia, 1 with major depression, 1 with stupor and the other with an extremely unbalanced diet) nor in 44 normal subjects without emaciation. These features were therefore thought to be characteristic and of diagnostic significance.
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PMID:Peculiar enlargement of the nasopharynx in patients with anorexia nervosa. 874 5

A case of difficulties in diagnosis of anorexia nervosa in a 15-year-old girl is reported. Before 1960, anorexia nervosa was rarely recognized, and bulimia was not known, as a nosological entity. Over the last two decades the occurrence of anorexia nervosa and bulimia has been on the rise. The disorders of ingestion usually begin as merely dietetic habits. However, they may, lead to heavy losing of weight accompanied by emaciation. Successful treatment depends on appropriate therapy managed by a psychologist, psychiatrist and endocrinologist.
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PMID:[Vomiting as a symptom of a developing psychological eating disorder in a 15-year old girl]. 917 60

In order to investigate the risk factors, pathogenesis and natural course of the osteoporosis frequently seen in anorexia nervosa, we measured the bone mineral density (BMD) of the lumbar spine using dual X-ray absorptiometry in 51 Japanese female patients with anorexia nervosa, and followed the change in BMD of 29 patients for 11 to 46 months. We also evaluated the serum osteocalcin and the urinary CrossLaps, degradation products of collagen I, in 103 samples obtained from 51 patients. There was a significant correlation between the spinal BMD and the duration of emaciation below a body mass index (BMI) of 15kg/m2 (r= -0.652, P<0.0001) and 16kg/m2 (r= -0.647, P<0.0001). The increase in BMD per year in the 29 patients significantly correlated with the BMI at the time of entry of each follow-up period (r= 0. 712, P<0.0001). The critical BMI for a positive increase in BMD was 16.4+/-0.3 kg/m2 (mean+/-S.E.M.). The serum osteocalcin declined, while the urinary CrossLaps increased in proportion to a decrease in BMI. Both markers were normalized in patients whose BMI was between 16.4 and 18.5 kg/m2. The ratio of urinary CrossLaps to serum osteocalcin correlated with BMI (r= -0.664, P<0.0001). We conclude that the body weight history is the most important predictor of the presence of osteoporosis as well as of recovery The BMD of patients does not increase to the normal range even several years after the recovery from this disorder, and they remain a high-risk group for osteoporosis in the future.
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PMID:The importance of body weight history in the occurrence and recovery of osteoporosis in patients with anorexia nervosa: evaluation by dual X-ray absorptiometry and bone metabolic markers. 975 36

Although anorexia nervosa emerged as a new syndrome in the second half of the 19th century, this clinical picture seemed to be unknown in the psychiatric hospitals or asylums. In asylum medicine, the commonly used concept of sitophobia to designate food refusal in the insane covered a wide variety of mental disturbances and cannot be plainly equated with anorexia nervosa. A major difference is the occurrence of hallucinations and delusions specifically centered around religion and digestion. Most probably, anorectic patients were not treated in asylums, but at home, in the doctor's office, or in general hospitals. This pattern may be partly attributed to the fact that both patients and doctors were focusing on symptoms of self-starvation like emaciation, constipation, and amenorrhea, which were primarily interpreted as referring to somatic diseases. Additionally, wealthy families probably preferred private care in water-cure establishments, sanatoria, and rest homes to the stigmatizing referral of their anorectic daughter to an asylum. Hence, the fact that late 19th-century institutionalized psychiatry was only incidentally confronted with anorexia nervosa may explain its lack of interest in the emerging syndrome.
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PMID:Food refusal and insanity: sitophobia and anorexia nervosa in Victorian asylums. 1074 45


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