Lipid profile: includes cholesterol (including total cholesterol, HDL and LDL) and triglycerides. Serum cholinesterase test: a test of liver enzymes (acetylcholinesterase and pseudocholinesterase) useful as a test of liver function and to assess the effects of malnutrition. Liver Function Test: A series of tests used to assess liver function some of the tests are also used in the assessment of malnutrition, protein deficiency, kidney function, bleeding disorders, and Crohns Disease. Luteinizing hormone (LH) response to gonadotropin-releasing hormone (GnRH): Tests the pituitary glands response to GnRh, a hormone produced in the hypothalamus. Hypogonadism is often seen in anorexia nervosa cases. Creatine kinase (CK) test: measures the circulating blood levels of creatine kinase an enzyme found in the heart (CK-MB), brain (CK-BB) and skeletal muscle (CK-MM). Blood urea nitrogen (BUN) test: urea nitrogen is the byproduct of protein metabolism first formed in the liver then removed from the body by the kidneys. The BUN test is primarily used to test kidney function. A low BUN level may indicate the effects of malnutrition. BUN-to-creatinine ratio: A BUN to creatinine ratio is used to predict various conditions. A high BUN/creatinine ratio can occur in severe hydration, acute kidney failure, congestive heart failure, and intestinal bleeding. A low BUN/creatinine ratio can indicate a low protein diet, celiac disease, rhabdomyolysis, or cirrhosis of the liver. Electrocardiogram (EKG or ECG): measures electrical activity of the heart. It can be used to detect various disorders such as hyperkalemia. Electroencephalogram (EEG): measures the electrical activity of the brain.
DSM-5
Anorexia nervosa is classified under the Feeding and Eating Disorders in the latest revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM 5). There is no specific BMI cut-off that defines low weight required for the diagnosis of anorexia nervosa.The diagnostic criteria for anorexia nervosa (all of which needing to be met for diagnosis) are:
Restriction of energy intake relative to requirements leading to a low body weight. (Criterion A)
Intense fear of gaining weight or persistent behaviors that interfere with gaining weight. (Criterion B)
Disturbance in the way a persons weight or body shape is experienced or a lack of recognition about the risks of the low body weight. (Criterion C)Relative to the previous version of the DSM (DSM-IV-TR), the 2013 revision (DSM5) reflects changes in the criteria for anorexia nervosa. Most notably, the amenorrhea (absent period) criterion was removed. Amenorrhea was removed for several reasons: it does not apply to males, it is not applicable for females before or after the age of menstruation or taking birth control pills, and some women who meet the other criteria for AN still report some menstrual activity. Subtypes
There are two subtypes of AN:
Binge-eating/purging type: patients with anorexia could show binge eating and purging behavior. It is different from bulimia nervosa in terms of the individuals weight. An individual with binge-eating/purging type anorexia is usually significantly underweight. People with bulimia nervosa on the other hand can sometimes be normal-weight or overweight.