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Circadian Rhythms of Body Temperature in Patients with Anorexia Nervosa, Hypothermia and Hypophosphatemia

  • S. Yoshiue
  • T. Kanamori
  • H. Sekine
  • A. Maeda
  • M. Ishida
  • J. Ogata
  • T. Kato
Chapter
Part of the APS Advances in Pharmacological Sciences book series (APS)

Abstract

Anorexia nervosa is a prolonged illness principally affecting young girls after puberty. The clinical manifestations include self-induced, severe weight loss, amenorrhea and psychopathology. The etiology has been studied extensively (1,2) but remains unknown. Central body temperature in patients with anorexia nervosa may be reduced by up to 1°C. Patients with marked weight loss show a fall in plasma levels of LH, FSH and estrogens reflecting hypothalamo-pituitary dysfunction. This has led to the suggestion that the hypothermia in anorexia nervosa may reflect a disorder of the hypothalamic thermoregulatory centers (3). Measurements of the thermal responses to exercise demonstrated that patients with anorexia nervosa can regulate body temperature in a thermoneutral environment (4). The onset of vasodilation following immersion of an arm in a hot water bath is delayed in these patients (5) indicating a shift in the threshold temperature for vasodilation (6). Our own studies confirmed the hormonal dysfunction although circadian temperature rhythms were normal (7). Itoh (8) has suggested that hypothalamic dysfunction may be a dominant factor in the pathophysiology of anorexia nervosa. In case reports of two severely affected patients the hypothermia was accompanied by respiratory distress, hyperventilation and hypophosphatemia (9–11). The present study was undertaken to investigate the relationship of the hypothermia and hypophosphatemia in this rare syndrome.

Keywords

Circadian Rhythm Anorexia Nervosa Bulimia Nervosa Severe Weight Loss Hypothalamic Dysfunction 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Garfinkel, PE, Kaplan, AS (1986): Anorexia nervosa: Diagnostic conceptualizations. In: Handbook of Eating Disorders. Physiology, Psychology, and Treatment of Obesity, Anorexia, and Bulimia. Brownell, KD, Foreyt, JP eds. New York: Basic Books, 266–282.Google Scholar
  2. 2.
    Demitrack, MA, Szostak, C, Weingartner, H (1992): Cognitive dysfunction in eating dis orders: A clinical psychobiological perspective. In: Cognitive Neuropsychology in Clinical Practice. Margolin, DI eds. New York, Oxford: Oxford University Press, 96–127.Google Scholar
  3. 3.
    Mecklenburg, RS, Loriaux, DL, Thompson, RH, Andersen, AE, Lipsett, MB (1974) Hypothalamic dysfunction in patients with anorexia nervosa, Medicine 53, 147–159.PubMedCrossRefGoogle Scholar
  4. 4.
    Davis, CTM, Fohlin, L, Thoren, C (1977): Temperature regulation in anorexia nervosa. J Physiol 268, 8.Google Scholar
  5. 5.
    Wakeling, A, Russell, GFM (1970): Disturbances in the regulation of body temperature in anorexia nervosa. Psychol Med 1, 30–39.PubMedCrossRefGoogle Scholar
  6. 6.
    Luck, P, Wakeling, A (1980): Altered thresholds for thermoregulatory sweating and vasodilatation in anorexia nervosa. Br Med J 281, 906–908.PubMedCrossRefGoogle Scholar
  7. 7.
    Yamada, K, Takeuchi, H, Yazumi, T, Ito, H, Yoshizawa, H, Yoshiue, S, Ishida, M (1986): Study of body temperature in anorexia nervosa. The Autonomic Nervous System 23, 1016.Google Scholar
  8. 8.
    Ito, H (1990): Simultaneous measurement of temperatures at different sites in clinical entities displaying hypothermia. The Autonomic Nervous System 27, 281–291.Google Scholar
  9. 9.
    Knochel, JP (1977): The pathophysiology and clinical characteristics of severe hypophosphatemia. Arch Intern Med 137, 203–220.PubMedCrossRefGoogle Scholar
  10. 10.
    Gustavsson, CG, Eriksson, L (1989): Acute respiratory failure in anorexia nervosa with hypophosphatemia. J Intern Med 225, 63–64.PubMedCrossRefGoogle Scholar
  11. 11.
    Levy, LA (1980): Severe hypophosphatemia as a complication of the treatment of hypothermia. Arch Intern Med 140, 128–129.PubMedCrossRefGoogle Scholar
  12. 12.
    Yoshiue, S, Yoshizawa, H, Itoh, H, Yazumi, T, Nakamura, M, Sekine, H, Takahashi, T, Kanamori, H, Suzuki, N, Ihashi, N, Sakaki, R, Ishida, M, Ogata, J (1992): Circadian body temperature in patients with psychogenic prolonged hyperthermia. In: Thermoregulation: The Pathophysiological Basis of Clinical Disorders. Lomax, P, Schönbaum, E eds. Basel: Karger, 157–166.Google Scholar

Copyright information

© Birkhäuser Verlag Basel 1994

Authors and Affiliations

  • S. Yoshiue
    • 1
  • T. Kanamori
    • 1
  • H. Sekine
    • 1
  • A. Maeda
    • 1
  • M. Ishida
    • 1
  • J. Ogata
    • 2
  • T. Kato
    • 1
  1. 1.1st Department of Internal MedicineSaint Marianna University School of MedicineKawasaki, Kanagawaken, 216Japan
  2. 2.Faculty of Home EconomicsKyouritsu Women’s UniversityChiyoda-ku, Tokyo, 1011Japan

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