ABSTRACT
BACKGROUND/OBJECTIVES: Anemia, leukopenia and, although less frequently, thrombocytopenia are possible hematological complications of anorexia nervosa considered strictly secondary to chronic malnutrition. This is a retrospective study on the prevalence of these disorders in a large cohort of 318 female patients with AN (20.4±5.6 years, body mass index (BMI) 15.9±1.6 kg/m2), recruited in the Outpatient Unit for Malnutrition secondary to Eating Disorders at the Department of Clinical Medicine and Surgery, Federico II University Hospital, since February 1991 to December 2012. SUBJECTS/METHODS: Patients were studied on an outpatient basis after obtaining medical history, clinical examination, routine hematobiochemical and endocrine tests, electrocardiography, psychiatric interview and bioelectrical impedance analysis and, in particular, phase angle determination. All patients with other comorbidities, in particular with mean corpuscular volume <80 fl, were excluded for suspected genetic alteration in the synthesis of hemoglobin. RESULTS: Hematologic data showed that 16.7% of patients had anemia, 7.9% neutropenia and 8.9% thrombocytopenia. These abnormalities were strictly related to the duration of illness (P=0.028), and to protein energy malnutrition, in particular, BMI and phase angle (P<0.001). CONCLUSIONS: Our study offers description of the incidence of hematologic defects in a selected and large sample of AN female patients, suggesting that its incidence is related to the degree and duration of protein energy malnutrition.
Subject(s)
Anorexia Nervosa/complications , Hematologic Diseases/epidemiology , Adolescent , Adult , Anorexia Nervosa/blood , Child , Cohort Studies , Dietary Proteins , Female , Hematologic Diseases/blood , Hematologic Diseases/complications , Humans , Incidence , Italy/epidemiology , Middle Aged , Prevalence , Retrospective Studies , Young AdultABSTRACT
First described by Walch in 1991, the posterosuperior glenoid rim impingement syndrome is a major condition in the differential diagnosis of shoulder pain occurring in the athletes engaged in repetitive and loading movements of abduction and extra-rotation of the dominant upper limb. Thirty-eight athletes with these dynamic athletic characteristics, referred for unexplained shoulder pain and with a clinical diagnosis of posterosuperior glenoid rim impingement syndrome, underwent radiography and MR examinations, with excellent final results. Radiography was capable of depicting the abnormal skeletal features of this kind of impingement, thus allowing a preliminary diagnosis to be made. MRI excelled in diagnosing the lesions in the deep surface of the supraspinatus tendon and in the posterior labrum secondary to impingement. The static and the kinematic sequences with the arm in abduction and extrarotation proved to be the best ones to define the physiopathologic phases of impingement. Thus, we conclude that invasive diagnostic procedures are not necessary for the correct and unquestionable diagnosis of posterosuperior glenoid rim impingement syndrome.
Subject(s)
Athletic Injuries/diagnosis , Magnetic Resonance Imaging , Shoulder Injuries , Shoulder Joint/diagnostic imaging , Shoulder Joint/pathology , Adolescent , Adult , Diagnosis, Differential , Female , Humans , Joint Instability/diagnosis , Male , Radiography , Rotator Cuff/diagnostic imaging , Rotator Cuff/pathology , Rotator Cuff Injuries , SyndromeABSTRACT
The authors report on a rare case of glomus tumor of the knee. Particular attention is given to the clinical features and the diagnostic difficulties.
