Anorexia Nervosa Differential Diagnoses

Updated: Apr 14, 2023
  • Author: Bettina E Bernstein, DO; Chief Editor: Caroly Pataki, MD  more...
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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

  • Cystic fibrosis (if the patient has pulmonary and/or pancreatic symptoms)

  • Cytomegalovirus esophagitis, cytomegalovirus colitis

  • Esophageal motility disorders, esophageal spasm, esophageal stricture [95]

  • 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) [96]

  • Pellagra

  • Rash (due to low zinc) [97]

  • Sheehan syndrome

  • Systemic lupus erythematosus (SLE)

Differential Diagnoses