The Paradox of Normal Serum Albumin in Anorexia Nervosa

ABSTRACT: Anorexia nervosa (AN) is associated with marked decreases in caloric intake and a corresponding reduction in body weight due to abnormal self-body image. Although counterintuitive, hypoalbuminemia and vitamin deficiencies are not expected consequences of this disorder. Etiologic considerations for hypoalbuminemia are discussed.

The case report of a patient with AN and marked hypoalbuminemia is presented and a focused literature review is reported. Hypoalbuminemia was initially attributed to starvation. However, occult infection was ultimately responsible. Serum albumin concentration normalized with antibiotic therapy despite minimal restoration of body weight.

Hypoalbuminemia should not be considered a characteristic feature of AN even in the setting of progressive weight loss. The presence of other potentially life‐threatening conditions should be sought, as reduced serum albumin concentration is a marker of inflammation in AN.

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1. Krantz MJ, Lee D, Donahoo WT, Mehler PS. The Paradox of Normal Serum Albumin in Anorexia Nervosa: A Case Report. International Journal of Eating Disorders 37(3):278-280, 2005. DOI: 10.1002/eat.20129