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(PSYCHIATRIC TIMES) - Evaluation of intermittently discolored, cold fingers was sought by a 39-year-old woman with long-standing anorexia nervosa. The patient had never smoked and was not taking any vasoconstrictive drugs.

Examination revealed an emaciated woman who was 163 cm (5 ft 4 in) tall and weighed 38 kg (84 lb). Her fingers were palpably cool, erythrocyanotic, mildly swollen, and xerotic. Bilateral radial and ulnar pulses were palpable, and an Allen test revealed no occlusion of the distal ulnar or radial arteries. An extensive serologic workup for underlying blood dyscrasias, paraproteinemias, collagen vascular disease, and vasculitis/vasculopathy was unremarkable.

Drs Steven M. Dean and Jean Starr of Columbus, Ohio, diagnosed anorexia nervosa–associated Raynaud phenomenon. Peripheral vasoconstriction is not uncommon in severely affected anorexic patients.

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