Table 1.
Summary of studies and case reports of pulmonary structure and function in anorexia nervosa
| 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 |
± Non-smokers
*Smoking status not clarified
¥Smokers included
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, c̅ 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