Delayed Diagnoses: Nonspecific Findings and Diagnostic Challenges in Eating Disorders

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 re...

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Main Authors: Dan Schwarz, Kathryn L. Ponder, Edward R. Feller
Format: Article
Language:English
Published: Wiley 2009-01-01
Series:Case Reports in Medicine
Online Access:http://dx.doi.org/10.1155/2009/841037
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author Dan Schwarz
Kathryn L. Ponder
Edward R. Feller
author_facet Dan Schwarz
Kathryn L. Ponder
Edward R. Feller
author_sort Dan Schwarz
collection DOAJ
description 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.
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spelling doaj-art-4643d93b466d446fb523675759f9ab2a2025-08-20T03:36:14ZengWileyCase Reports in Medicine1687-96271687-96352009-01-01200910.1155/2009/841037841037Delayed Diagnoses: Nonspecific Findings and Diagnostic Challenges in Eating DisordersDan Schwarz0Kathryn L. Ponder1Edward R. Feller2Alpert School of Medicine, Brown University, Providence, RI, USAAlpert School of Medicine, Brown University, Providence, RI, USADepartment of Internal Medicine, Alpert School of Medicine, Brown University, Providence, RI, USAObjective. 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.http://dx.doi.org/10.1155/2009/841037
spellingShingle Dan Schwarz
Kathryn L. Ponder
Edward R. Feller
Delayed Diagnoses: Nonspecific Findings and Diagnostic Challenges in Eating Disorders
Case Reports in Medicine
title Delayed Diagnoses: Nonspecific Findings and Diagnostic Challenges in Eating Disorders
title_full Delayed Diagnoses: Nonspecific Findings and Diagnostic Challenges in Eating Disorders
title_fullStr Delayed Diagnoses: Nonspecific Findings and Diagnostic Challenges in Eating Disorders
title_full_unstemmed Delayed Diagnoses: Nonspecific Findings and Diagnostic Challenges in Eating Disorders
title_short Delayed Diagnoses: Nonspecific Findings and Diagnostic Challenges in Eating Disorders
title_sort delayed diagnoses nonspecific findings and diagnostic challenges in eating disorders
url http://dx.doi.org/10.1155/2009/841037
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AT kathrynlponder delayeddiagnosesnonspecificfindingsanddiagnosticchallengesineatingdisorders
AT edwardrfeller delayeddiagnosesnonspecificfindingsanddiagnosticchallengesineatingdisorders