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Table 1 Summary of studies and case reports of pulmonary structure and function in anorexia nervosa

From: Pulmonary complications of eating disorders: a literature review

Author

Sample

Sample

Age or mean Age of AN cohort (years)

Weight

Sex

Findings

Birmingham et al.* [48]

Case report

1 AN-R

49

BMI 15.4 kg/m2

M

PFTs: RMS after weight restoration to BMI 18 kg/m2. Imaging: nml CXR

Cook et al. [37]±

Case report

1 AN-R

34

49%IBW

F

PFTs: Restrictive pattern, marked reduction in DLCO and RMS and elevated RV. Imaging: CT c̅ bullae, bronchiectasis and mild, generalized emphysema

Coxson et al. [35]¥

Prospective

21 AN, 16 HC

36

mBMI 18 kg/m2

F

PFTs: As BMI decreases, DLCO decreases. No difference in RV, TLC between AN & HC. Imaging: CTs c̅ emphysematous changes

Day et al. [39] ±

Case report

1 AN-R

30

BMI 10 kg/m2

M

PFTs: none Imaging: CT c̅ R sided bullous disease c̅ a moderate anterior PTX, bl cavitary lesions and bronchiectasis. Dx: severe bullous emphysema

Gardini Gardenghi et al.* [30]

Prospective

27 AN, 18 HC

24

mBMI 16.2 kg/m2

Not provided

PFTs: Reduced DLCO and RMS in AN vs. HC. Imaging: CT in n = 8 AN nml

Gonzalez-Moro et al. ± [31]

Prospective

12 AN, 10 HC

24.7

mBMI 16.1 kg/m2

F

PFTs: Increased RV, RV/TLC, FRC and decreased RMS in AN vs HC. DLCO not undertaken. Imaging: None. Other: Reduced respiratory response to hypercapnia. No difference in ABG

Kerem et al. [25]±

Prospective

16 AN

15

mBMI 15.5 kg/m2

12 F, 4 M

PFTs: normal except decreased PEF. Other: Hypercapnia on admission

Kerem et al. [26]*

Retrospective

45 AN-R

15

mBMI 15.2 kg/m2

37 F, 8 M

Other: Mild respiratory acidosis observed in 78% of patients on admission

Minano Garrido et al.* [34]

Prospective

18 AN-R, 5 AN-BP

25.6

mBMI 11.4 kg/m2

F

PFTs: Reduced RMS and PEF, improved c̅ partial weight recovery. Imaging: None

Murciano et al. [33]*

Prospective

15 AN

N/a

63%IBW

Not provided

PFTs: reduced RMS, reduced FEV1 and VC improved at 30 days, nml lung volumes otherwise. Imaging: None Other: normal ABGs. 4 patients with hypercapnia

Park et al. [38] ±

Case report

1 AN-BP

43

BMI 9.8 kg/m2

F

PFTs: Restrictive pattern; reduced VC, TLC, and DLCO. Increased RV. Improved at 6 yr f/u after 22 kg weight gain

Imaging: CT c̅ large bullae of apex of L lung; diffuse emphysema and bronchiectasis. Decreased bullae size and improved emphysema at 6 yr f/u

Pieters et al. [32]¥

Prospective

24 AN

21.3

mBMI 14 kg/m2

F

PFTs: Reduced RMS, increased RV. Nml DLCO

Imaging: None

Ryan et al. 42]*

Case report

1 AN-R

25

46% IBW

F

PFTs: Restrictive pattern; reduced RMS, reduced ventilatory response to hypercapnia. All improved c̅ refeeding

Imaging: Nml CXR

Saran et al. [40] ±

Case report

1 AN-R

30

BMI 9.2 kg/m2

F

PFTs: none. Imaging: CT c̅ Bronchiectasis

Sheu et al. [41]*

Case report

1 AN-BP

18

BMI 10.2 kg/m2

F

PFTs: Reduced RMS. Imaging: CXR c̅ hyperinflation and decreased pulmonary vascular markings

  1.  ± Non-smokers
  2. *Smoking status not clarified
  3. ¥Smokers included
  4. ABG Arterial blood gas, bl Bilateral, DLCO Diffusion capacity of CO2, FRC Functional reserve capacity, PFT Pulmonary function test, RV = Residual volume, AN Anorexia nervosa, with, dx Diagnosis, L Left, PTX Pneumothorax, TLC Total lung capacity, AN-BP Anorexia nervosa, binge/purge subtype, CT Computed tomography of the lungs, f/u Follow up, nml Normal, R Right, VC Vital capacity, AN-R Anorexia nervosa, restricting subtype, CXR Chest x-ray, FEV1 Forced expiratory volume in 1 s, PEF Peak expiratory flow, RMS Respiratory muscle strength, yr Year