Abstract
Objective Acrocyanosis (AC) is a common manifestation of starving syndrome in anorexia nervosa. We characterized microvascular changes associated with AC and determined discriminating factors between acrally symptomatic and nonsymptomatic patients. Methods We examined 34 patients with anorexia nervosa (15 restrictive–anorectic type, 19 binge-eating/purging type, duration 1–25 years). Nineteen were symptomatic (SP) and 15 were nonsymptomatic (NSP). All underwent photo-pletysmography, sonography of the brachial artery, capillary microscopy and laboratory analysis. Results Disease characteristics and body mass index did not differ between SP and NSP. In SP more dilatated efferent capillary loops and venoles were present ( P<.001) and capillary flow velocities were reduced (0.21±0.12 ml/min vs. 0.34±0.15 ml/min; P=.015). Flow-mediated and nitroglycerin-induced dilatation showed no differences. Symptomatic patients had lower leukocyte counts ( P=.008), lower eosinophils ( P=.003) and lower LDL ( P=.045) concentrations. A logistic regression model identified only leukocytes ( P=.017) and eosinophils ( P=.023) to be associated with AC. Conclusions In acrally symptomatic patients the typical microvascular features of AC are present. AC is associated with lower leukocyte counts and lower eosinophils.
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