Characterized by extreme voluntary weight loss due to self-starvation or binge eating followed by purging, AN occurs in 0.5-3% of the female population [3, 4]. Clinical signs and symptoms of AN include an emaciated appearance, prepubertal features, lethargy, lanugo, alopecia, acrocyanosis, hypothermia, swollen joints, pitting edema, and bradycardia and hypotension. Biochemical evaluation often shows fluid and electrolyte disturbances and hypercarotenemia as well as endocrine and hematologic abnormalities such as hypothyroidism and anemia, respectively. Several cardiovascular irregularities develop along with a host of gastrointestinal complications, particularly in those with the binge eating-purging type of AN. Osteoporosis and skeletal fractures are common in persons with AN. Some may experience peripheral neuropathy and seizures. Mortality is as high as 22% in women with long-term AN .
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