Low insulin-like growth factor I and leukopenia in anorexia nervosa.

OBJECTIVE: Considering that leukopenia and anemia are commonly observed in anorexia nervosa (AN) and that growth hormone (GH) and insulin-like growth factor-I (IGF-I) markedly influence the activation, growth and survival of hemopoietic cells, we sought for possible relationships between hematologic parameters and the GH-IGF-I axis in a group of patients with AN. METHOD: Twenty patients were studied. Leukocyte and erythrocyte counts, as well as baseline serum GH levels and IGF-I standard deviation score (SDS) values, were determined in each participant and correlations between parameters were searched. RESULTS: Leukocyte and erythrocyte counts, as well as IGF-I SDS values, were significantly lower, conversely GH was significantly higher in AN patients than in normal weight participants. In patients, IGF-I SDS values were positively correlated with leukocyte count and BMI, whereas no correlation was found between IGF-I SDS and hemoglobin or erythrocytes. CONCLUSION: The demonstration of a positive correlation between leukocyte number and circulating IGF-I in AN suggests a likely pathogenetic role of IGF-I deficiency in this hematologic abnormality.

Pericardial effusion requiring pericardiocentesis in a girl with anorexia nervosa.

OBJECTIVE: Silent pericardial effusion is frequently observed in patients with anorexia nervosa. The nature of the pericardial fluid could never be established, as pericardiocentesis was ethically unfeasible. METHOD: We describe the case of a girl with anorexia nervosa in whom an initial, clinically irrelevant pericardial effusion increased rapidly, making pericardiocentesis necessary to prevent cardiac tamponade. RESULTS: It was thus possible to exclude the inflammatory or infectious nature of the pericardial fluid, although the pathogenesis of this cardiac alteration remains obscure. CONCLUSION: Echocardiographic examination appears to be strongly advisable in patients with anorexia nervosa.