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Case Reports in Medicine
Volume 2009 (2009), Article ID 841037, 3 pages
http://dx.doi.org/10.1155/2009/841037
Case Report

Delayed Diagnoses: Nonspecific Findings and Diagnostic Challenges in Eating Disorders

1Alpert School of Medicine, Brown University, Providence, RI, USA
2Harvard School of Public Health, Harvard University, Boston, MA, USA
3Department of Internal Medicine, Alpert School of Medicine, Brown University, Providence, RI, USA

Received 26 April 2009; Accepted 12 July 2009

Academic Editor: Aliza Zeidman

Copyright © 2009 Dan Schwarz et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. Eating disorders commonly present with nonspecific findings, masquerading as other, more common etiologies of malnutrition and wasting. In low-prevalence populations, these ambiguities can complicate clinicians’ diagnostic reasoning, resulting in delayed or missed diagnoses. Method. We report the atypical case of a 51-year-old male with a five-year history of unexplained weight loss despite extensive past medical evaluation. Previous documentation of profound lymphopenia and bone marrow atrophy had not been linked to a known association with eating disorders. Results. Evaluation for medical etiologies of wasting was negative. Following psychiatric evaluation, the patient was diagnosed with an eating disorder, not otherwise specified, and admitted to a specialized nutritional rehabilitation program. Conclusion. The nonspecific clinical history, physical exam, and laboratory abnormalities of eating disorders can make these diagnoses challenging and delay appropriate treatment. Clinicians should consider eating disorders in patients with malnutrition, severe lymphopenias, and gelatinous marrow transformation early in their workup, so as to avoid potentially negative outcomes.