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Anorexia Nervosa Differential Diagnoses

  • Author: Bettina E Bernstein, DO; Chief Editor: Caroly Pataki, MD  more...
 
Updated: May 23, 2016
 
 

Diagnostic Considerations

Patients may or may not carry a diagnosis of anorexia nervosa when presenting to an emergency department for acute care, and other physiologic causes of malnutrition, weight loss, and amenorrhea, including the following, must be ruled out before making the diagnosis:

  • Cancer
  • Cardiac valvular disease
  • Cataracts
  • Chronic, undiagnosed organic disease (infectious, congenital, or metabolic)
  • Clostridium difficile colitis, clostridial cholecystitis
  • Cytomegalovirus esophagitis, cytomegalovirus colitis
  • Esophageal motility disorders, esophageal spasm, esophageal stricture
  • Inflammatory bowel disease, including Crohn disease and ulcerative colitis
  • Low vitamin D and calcium levels (hypocalcinosis)
  • Myeloma
  • Occult infection (if heart rate is normal or elevated)
  • Osteopenia
  • Osteoporosis
  • Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) (rare)[89]
  • Pellagra
  • Rash (due to low zinc)[90]
  • Sheehan syndrome
  • Systemic lupus erythematosus (SLE)

Differential Diagnoses

 
 
Contributor Information and Disclosures
Author

Bettina E Bernstein, DO Distinguished Fellow, American Academy of Child and Adolescent Psychiatry; Distinguished Fellow, American Psychiatric Association; Clinical Assistant Professor of Neurosciences and Psychiatry, Philadelphia College of Osteopathic Medicine; Clinical Affiliate Medical Staff, Department of Child and Adolescent Psychiatry, Children's Hospital of Philadelphia; Consultant to theVillage, Private Practice; Consultant PMHCC/CBH at Family Court, Philadelphia

Bettina E Bernstein, DO is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, American Psychiatric Association

Disclosure: Nothing to disclose.

Chief Editor

Caroly Pataki, MD Health Sciences Clinical Professor of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, David Geffen School of Medicine

Caroly Pataki, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, New York Academy of Sciences, Physicians for Social Responsibility

Disclosure: Nothing to disclose.

Acknowledgements

Edward Bessman, MD, MBA Chairman and Clinical Director, Department of Emergency Medicine, John Hopkins Bayview Medical Center; Assistant Professor, Department of Emergency Medicine, Johns Hopkins University School of Medicine

Edward Bessman, MD, MBA is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Barry E Brenner, MD, PhD, FACEP Professor of Emergency Medicine, Professor of Internal Medicine, Program Director for Emergency Medicine, Case Medical Center, University Hospitals, Case Western Reserve University School of Medicine

Barry E Brenner, MD, PhD, FACEP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Chest Physicians, American College of Emergency Physicians, American College of Physicians, American Heart Association, American Thoracic Society, Arkansas Medical Society, New York Academy of Medicine, New York Academy of Sciences, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Tracy A Cushing, MD, MPH, FACEP, FAWM Assistant Professor, Department of Emergency Medicine, University of Colorado School of Medicine; Attending Physician, Denver Health Medical Center

Tracy A Cushing, MD, MPH, FACEP, FAWM is a member of the following medical societies: American College of Emergency Physicians, Society for Academic Emergency Medicine, and Wilderness Medical Society

Disclosure: Nothing to disclose.

Angelo P Giardino, MD, PhD, MPH Associate Professor, Baylor College of Medicine; Chief Medical Officer, Texas Children's Health Plan; Chief Quality Officer, Medicine, Texas Children's Hospital

Angelo P Giardino, MD, PhD, MPH is a member of the following medical societies: Academic Pediatric Association, American Academy of Pediatrics, American Professional Society on the Abuse of Children, Harris County Medical Society, Helfer Society, and International Society for the Prevention of Child Abuse and Neglect

Disclosure: Bayer Honoraria Review panel membership; Pfizer Grant/research funds Independent contractor; Strategic Healthcare Alliance Honoraria Board membership; Health Resources and Services Administration (HRSA) Integrated Community Systems for CSHCN Grant Grant/research funds Other; CLS Bering Grant/research funds Other

Robert Harwood, MD, MPH, FACEP, FAAEM Senior Physcian, Department of Emergency Medicine, Advocate Christ Medical Center; Assistant Professor, Department of Emergency Medicine, University of Illinois at Chicago College of Medicine

Robert Harwood, MD, MPH, FACEP, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, Council of Emergency Medicine Residency Directors, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Leah E Jacoby, MD Resident Physician, Department of Emergency Medicine, Denver Health Medical Center, University of Colorado School of Medicine

Leah E Jacoby, MD is a member of the following medical societies: American College of Emergency Physicians and Emergency Medicine Residents Association

Disclosure: Nothing to disclose.

Jennifer DA Liburd, MD Consulting Staff, Assistant Professor of Pediatrics, Department of Pediatric Emergency Medicine, Nyack Hospital

Jennifer Da Liburd is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Siobhan E O'Herron, MD Resident Physician, Department of Psychiatry, Harvard Medical School

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Ron D Waldrop, MD, MS, FAAP, FACEP, FACPE Attending Physician, Pediatric Emergency Medicine, Huntsville Women’s and Children’s Hospital; Assistant Clinical Professor, Georgetown University School of Medicine

Ron D Waldrop, MD, MS, FAAP, FACEP, FACPE is a member of the following medical societies: American Academy of Pediatrics, American College of Emergency Physicians, American College of Physician Executives, and National Association for Healthcare Quality

Disclosure: Nothing to disclose.

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

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