Evaluation of immunocompetence and nutritional status in patients with bulimia nervosa

Nutritional status of patients suffering from bulimia nervosa was evaluated by anthropometric, hematological, and immunological parameters in comparison with a healthy control group. Anthropometry showed no signs of malnutrition in either group. Bulimic patients showed a significant decrease in most of the routine clinical indexes related to red blood cells. Lymphocyte subsets CD2 and CD4 in bulimic patients were lower than in controls, whereas CD8 remained unmodified, leading to a lower CD4:CD8 in bulimic patients. The decreases in CD2 and CD4 numbers might be linked to an impaired cell-mediated immune function, as evaluated by the response to skin tests. The B lymphocyte subset was increased in the bulimic group. Innate immunity was impaired in the bulimic patients. Although anthropometric and most of the routine clinical parameters were within the normal range, these results might suggest that the depleted immune function accounts for a subclinical malnutrition status in bulimic patients.