Lymphocyte subsets and the increased risk for opportunistic infections in severe restrictive anorexia nervosa

Restrictive anorexia nervosa (AN-R) is characterized not only by psychiatric manifestations but also by significant medical complications. Patients commonly exhibit immune alterations, potentially increasing their susceptibility to infections. While direct evidence linking AN-R to heightened rates of opportunistic infections remains inconclusive, clinical observations suggest a higher incidence of complications and delayed febrile response in patients with infections. Concurrently, malnutrition, a frequent cause of secondary immunodeficiencies, exacerbates this susceptibility by compromising immune function. This paper investigates the immunological profiles of two patients with long-term AN-R who developed severe infections: one with disseminated Mycobacterium kansasii and the other with a co-infection of pulmonary Aspergillus fumigatus and Mycobacterium celatum. These cases, alongside data collected from previously published case reports summarized in this study, highlight the impact of altered immune function associated with mentioned population. The paper aims to explain the underlying mechanisms of immune dysfunction. Proactive monitoring of immune status and incorporating such assays into clinical practice may benefit early detection, effective management, and ultimately, improved outcomes.