Comparison of disease severity in adolescents with anorexia nervosa and atypical anorexia nervosa
European Journal of Pediatrics, cilt.184, sa.12, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 184 Sayı: 12
- Basım Tarihi: 2025
- Doi Numarası: 10.1007/s00431-025-06557-z
- Dergi Adı: European Journal of Pediatrics
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CINAHL, EMBASE
- Anahtar Kelimeler: Adolescent, Anorexia nervosa, Atypical Anorexia nervosa, Medical severity
- Hacettepe Üniversitesi Adresli: Evet
Özet
Purpose: Although atypical anorexia nervosa (AAN) is as common as anorexia nervosa (AN) it is often underrecognized due to normal or above-normal weight at presentation. We aimed to compare disease characteristics between adolescents with AN and AAN using a comprehensive panel of anthropometric, vital-sign, biochemical, and clinical variables. Methods: A retrospective chart review was performed for adolescents aged 12–18 years diagnosed with AN and AAN according to DSM-5 criteria. Anthropometric, vital-sign, and laboratory measurements, and hospitalization data at presentation were recorded. The weight loss percentage and rate, and vital instability data were categorized using the SAHM 2022 guideline.Results: Of 230 adolescents, 82 had AN (35.7%) and 148 had AAN (64.3%). No significant differences were found in terms of weight loss percentage (p = 0.453) or rate (p = 0.348). While the hypotension (p < 0.001) and hypothermia (p = 0.017) rates were significantly higher in AN, bradycardia and orthostatic changes did not differ. AN showed higher rates of elevated creatinine (p = 0.006), hyponatremia (p = 0.006), hypokalemia (p = 0.017), and hypercholesterolemia (p = 0.003), and hypogonadism (p < 0.001). Other laboratory abnormalities did not differ between the two groups. Hospitalization rates and time for vital instability recovery were similar between AN and AAN. However, adolescents with AN were eight-fold more likely to experience refeeding syndrome (p = 0.002). Conclusion: While adolescents with AN demonstrate more overt physiological compromise, those with AAN demonstrated comparably significant medical severity. These findings underscore that body weight alone is a misleading indicator of disease severity. Reducing weight bias and improving clinician awareness are critical to ensure timely recognition and care for AAN. (Table presented.)