RESUMO
Gelatinous bone marrow transformation (GMT), also known as starvation bone marrow, has been reported in a number of chronic illnesses, eating disorders (anorexia nervosa) and malignancies. We report the case of a 37-year-old man with a history of bipolar disorder and obesity (weighing >300 pounds) who presented due to recently developing a deep yellow colour to his skin. Over the past 2 years, through diet and exercise, he lost over 150 pounds. He reported running 6-8 miles per day and eating 'lots of squash'. We made the diagnosis of starvation hepatitis and bone marrow degeneration, and referred the patient to a dietician and haematologist/oncologist, where improvements were observed at 4 weeks follow-up.
Assuntos
Doenças da Medula Óssea/etiologia , Comportamento Alimentar/fisiologia , Redução de Peso/fisiologia , Adulto , Doenças da Medula Óssea/dietoterapia , Diagnóstico Diferencial , Hepatite/dietoterapia , Hepatite/etiologia , Humanos , Masculino , Obesidade/complicações , Inanição/complicaçõesRESUMO
If hematological abnormalities appear to be a common feature of severe anorexia nervosa, on the other hand bone marrow hypoplasia seems to be comparatively rare. We recently encountered a patient with anorexia nervosa who demonstrated a hypoplastic bone marrow associated with gelatinous transformation. These abnormalities were rapidly reversible with intensive nutritional rehabilitation. Bone marrow hypoplasia and gelatinous transformation are discussed in relation to current concepts of the role of nutrition in hematopoiesis in humans.