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Leukopenia in Anorexia Nervosa: Lack of Increased Risk of Infection

Leukopenia in Anorexia Nervosa: Lack of Increased Risk of Infection Abstract To determine whether patients with anorexia nervosa (AN) and leukopenia have an increased risk of infection, we reviewed the incidence of leukopenia and infection in 68 cases of AN and studied the mechanism of profound neutropenia in one. Compared with controls, patients with AN had substantially lower total leukocyte counts and absolute neutrophil, lymphocyte, and monocyte counts. Despite frequent and often severe panleukopenia, the patients with AN had no more infections than did the control subjects. The patient with severe neutropenia had a hypocellular bone marrow biopsy specimen showing relative myeloid hyperplasia, normal distribution of neutrophils between the marginal and circulating pools, and normal bone marrow neutrophil reserves as estimated by response to hydrocortisone sodium succinate. We conclude that patients with AN and associated leukopenia do not have increased infection propensity. (Arch Intern Med 138:1520-1523, 1978) References 1. Morlock CG: Anorexia nervosa . Proc Staff Meeting Mayo Clin 14:24-28, 1939. 2. Carryer HM, Berkman JM, Mason HL: Relative lymphocytosis in anorexia nervosa . Proc Staff Meeting Mayo Clin 32:426-432, 1959. 3. Pearson HA: Marrow hypoplasia in anorexia nervosa . J Pediatr 71:211-215, 1967.Crossref 4. Seidensticker JA, Tzagournis M: Anorexia nervosa-clinical features and long-term follow-up . J Chronic Dis 21:361-367, 1968.Crossref 5. Mant MJ, Faragher BS: The hematology of anorexia nervosa . Br J Haematol 23:737-749, 1972.Crossref 6. Warren MP, Vande Weile RL: Clinical and metabolic features of anorexia nervosa . Am J Obstet Gynecol 117:435-449, 1973. 7. Hurd HP II, Palumbo PJ, Gharib H: Hypothalamic-endocrine dysfunction in anorexia nervosa . Mayo Clin Proc 52:711-716, 1977. 8. Lucas AR: On the meaning of laboratory values in anorexia nervosa . Mayo Clin Proc 52:748-750, 1977. 9. Athens JW, Raab SO, Haab OP, et al: Leukokinetic studies: III. The distribution of granulocytes in the blood of normal subjects . J Clin Invest 40:159-163, 1961.Crossref 10. Bishop CR, Athens JW, Boggs DR, et al: Leukokinetic studies: XIII. A non-steady kinetic evaluation of the mechanism of cortisone-induced granulocytosis . J Clin Invest 47:249-260, 1968.Crossref 11. Rebuck JW, Crowley JH: A method for studying leukocytic functions in vivo . Ann NY Acad Sci 59:757-805, 1955.Crossref 12. Orfanakis NG, Ostlung RE, Bishop CR, et al: Normal blood leukocyte concentration values . Am J Clin Pathol 53:647-651, 1970. 13. Deinard AS, Page AR: An improved method for performing neutrophil survival studies . Blood 36:98-110, 1970. 14. Deinard AS, Fortuny IE, Theologides A, et al: Studies on the neutropenia of cancer chemotherapy . Cancer 33:1210-1218, 1974.Crossref 15. Bodey GP, Buckley M, Sathe YS, et al: Quantitative relationships between circulating leukocytes and infection in patients with acute leukemia . Ann Intern Med 64:328-340, 1966.Crossref 16. Pincus SH, Borer LA, Stossel TP: Chronic neutropenia in childhood: Analysis of 16 cases and a review of the literature . Am J Med 61:849-861, 1976.Crossref 17. Crosby WH: How many "polys" are enough . Arch Intern Med 123:722-723, 1969.Crossref 18. Brozek J, Wells S, Keys A: Medical aspects of semistarvation in Leningrad (seige 1941-1942) . Am Rev Soviet Med 4:70-88, 1946. 19. Drenick EJ, Alvarez LC: Neutropenia in prolonged fasting . Am J Clin Nutr 24:859-863, 1971. 20. Kanis JA, Brown P, Fitzpatrick K, et al: Anorexia nervosa—a clinical, psychiatric, and laboratory study: I. Clinical and laboratory investigation . Q J Med 43:321-338, 1974. 21. Gotch FM, Spry CJF, Mowat AG, et al: Reversible granulocyte killing defect in anorexia nervosa . Clin Exp Immunol 21:244-249, 1975. 22. Kim Y, Michael AF: Hypocomplementemia in anorexia nervosa . J Pediatr 87:582-585, 1975.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Leukopenia in Anorexia Nervosa: Lack of Increased Risk of Infection

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Publisher
American Medical Association
Copyright
Copyright © 1978 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1978.03630350050015
Publisher site
See Article on Publisher Site

Abstract

Abstract To determine whether patients with anorexia nervosa (AN) and leukopenia have an increased risk of infection, we reviewed the incidence of leukopenia and infection in 68 cases of AN and studied the mechanism of profound neutropenia in one. Compared with controls, patients with AN had substantially lower total leukocyte counts and absolute neutrophil, lymphocyte, and monocyte counts. Despite frequent and often severe panleukopenia, the patients with AN had no more infections than did the control subjects. The patient with severe neutropenia had a hypocellular bone marrow biopsy specimen showing relative myeloid hyperplasia, normal distribution of neutrophils between the marginal and circulating pools, and normal bone marrow neutrophil reserves as estimated by response to hydrocortisone sodium succinate. We conclude that patients with AN and associated leukopenia do not have increased infection propensity. (Arch Intern Med 138:1520-1523, 1978) References 1. Morlock CG: Anorexia nervosa . Proc Staff Meeting Mayo Clin 14:24-28, 1939. 2. Carryer HM, Berkman JM, Mason HL: Relative lymphocytosis in anorexia nervosa . Proc Staff Meeting Mayo Clin 32:426-432, 1959. 3. Pearson HA: Marrow hypoplasia in anorexia nervosa . J Pediatr 71:211-215, 1967.Crossref 4. Seidensticker JA, Tzagournis M: Anorexia nervosa-clinical features and long-term follow-up . J Chronic Dis 21:361-367, 1968.Crossref 5. Mant MJ, Faragher BS: The hematology of anorexia nervosa . Br J Haematol 23:737-749, 1972.Crossref 6. Warren MP, Vande Weile RL: Clinical and metabolic features of anorexia nervosa . Am J Obstet Gynecol 117:435-449, 1973. 7. Hurd HP II, Palumbo PJ, Gharib H: Hypothalamic-endocrine dysfunction in anorexia nervosa . Mayo Clin Proc 52:711-716, 1977. 8. Lucas AR: On the meaning of laboratory values in anorexia nervosa . Mayo Clin Proc 52:748-750, 1977. 9. Athens JW, Raab SO, Haab OP, et al: Leukokinetic studies: III. The distribution of granulocytes in the blood of normal subjects . J Clin Invest 40:159-163, 1961.Crossref 10. Bishop CR, Athens JW, Boggs DR, et al: Leukokinetic studies: XIII. A non-steady kinetic evaluation of the mechanism of cortisone-induced granulocytosis . J Clin Invest 47:249-260, 1968.Crossref 11. Rebuck JW, Crowley JH: A method for studying leukocytic functions in vivo . Ann NY Acad Sci 59:757-805, 1955.Crossref 12. Orfanakis NG, Ostlung RE, Bishop CR, et al: Normal blood leukocyte concentration values . Am J Clin Pathol 53:647-651, 1970. 13. Deinard AS, Page AR: An improved method for performing neutrophil survival studies . Blood 36:98-110, 1970. 14. Deinard AS, Fortuny IE, Theologides A, et al: Studies on the neutropenia of cancer chemotherapy . Cancer 33:1210-1218, 1974.Crossref 15. Bodey GP, Buckley M, Sathe YS, et al: Quantitative relationships between circulating leukocytes and infection in patients with acute leukemia . Ann Intern Med 64:328-340, 1966.Crossref 16. Pincus SH, Borer LA, Stossel TP: Chronic neutropenia in childhood: Analysis of 16 cases and a review of the literature . Am J Med 61:849-861, 1976.Crossref 17. Crosby WH: How many "polys" are enough . Arch Intern Med 123:722-723, 1969.Crossref 18. Brozek J, Wells S, Keys A: Medical aspects of semistarvation in Leningrad (seige 1941-1942) . Am Rev Soviet Med 4:70-88, 1946. 19. Drenick EJ, Alvarez LC: Neutropenia in prolonged fasting . Am J Clin Nutr 24:859-863, 1971. 20. Kanis JA, Brown P, Fitzpatrick K, et al: Anorexia nervosa—a clinical, psychiatric, and laboratory study: I. Clinical and laboratory investigation . Q J Med 43:321-338, 1974. 21. Gotch FM, Spry CJF, Mowat AG, et al: Reversible granulocyte killing defect in anorexia nervosa . Clin Exp Immunol 21:244-249, 1975. 22. Kim Y, Michael AF: Hypocomplementemia in anorexia nervosa . J Pediatr 87:582-585, 1975.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Oct 1, 1978

References