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Anorexia nervosa and senna misuse: nephrocalcinosis, digital clubbing and hypertrophic osteoarthropathy

Andrew F McLaughlin
Med J Aust 2008; 189 (6): . || doi: 10.5694/j.1326-5377.2008.tb02064.x
Published online: 15 September 2008

To the Editor: I read with interest the letter by Lim and colleagues on anorexia nervosa and senna misuse.1 I have seen abnormal whole body bone scans in patients with severe eating disorders of exactly the same pattern (except for the avid bilateral apical lung and gastric uptake) as the case described.


  • Burwood Nuclear Medicine, Sydney, NSW.


Correspondence: afm@nucmedburwood.com.au

  • 1. Lim AKH, Hook PH, Kerr PG. Anorexia nervosa and senna misuse: nephrocalcinosis, digital clubbing and hypertrophic osteoarthropathy [letter]. Med J Aust 2008; 188: 121-122. <MJA full text>
  • 2. Ali A, Tetalman MR, Fordham EW, et al. Distribution of hypertrophic pulmonary osteoarthropathy. Am J Roentgenol 1980; 137: 771-780.
  • 3. Fogelman I, Collier BD, Brown ML. Bone scintigraph. Part 3: bone scanning in metabolic bone disease. J Nucl Med 1993; 34: 2247-2252.
  • 4. McLaughlin AF. Uptake of 99mTc bone scanning agent by lungs with metastatic calcification. J Nucl Med 1975; 16: 322.
  • 5. Bloodworth J, Tomashefski RF Jr. Localised pulmonary metastatic calcification associated with pulmonary artery obstruction. Thorax 1992; 47: 174-178.
  • 6. World Health Organization. An assessment of fracture risk and its application to screening and postmenopausal osteoporosis. Report of a WHO Study Group. (Technical Report Series No. 84.) Geneva: WHO, 1994.

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