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Leukopenia and Anorexia Nervosa

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Leukopenia and Anorexia Nervosa
A blood test on a 14-year-old girl, who suffers from anorexia nervosa, revealed not only a leukopenia but a lymphocytosis. Is this common in anorexia patients?

Dr. L.M.P.C. Barbé

Patients with anorexia nervosa (AN) frequently suffer from a mild degree of anemia and from moderate leukopenia on top of their undernourished state and metabolic disarrangements. Research indicates a defective in vitro granulopoiesis in AN patients, manifested by a reduction of both granulocyte-macrophage hemopoietic progenitor cells and granulocyte-macrophage colony-stimulating factor. It has to be determined whether these changes are the result of the basic disease process or if they are due to malnutrition. Case reports have suggested the use of granulocyte colony-stimulating factor in an attempt to reverse the leukopenia.

Common causes of a lymphocytosis include infections such as Epstein-Barr virus, cytomegalovirus, and tuberculosis. Patients with AN may be immunocompromised and thus may be at risk for infection. Endocrine causes include hyperthyroidism and adrenal insufficiency; and then there are neoplastic causes such as chronic lymphocytic leukemia.

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