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LEONARD H. SIGAL, MD
Departments of Medicine and Molecular Genetics & Microbiology University of Medicine and Dentistry of New Jersey 675 Hoes Lane Piscataway, NJ 08854-5635

BARBARA K. SNYDER, MD
Department of Pediatrics Cornell University School of Medicine 1200 York Ave New York, NY 10021

Am J Dis Child. 1989;143(12):1391-1392.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Sir.—We read the review written by Eichenfield and Johnston,¹ in the May 1989 issue of AJDC with great interest, but must disagree with one point, made in Table 1 and in the text. Much of the literature in immunology deals with the abnormalities of anorexia nervosa as if they were the same as the changes seen in malnutrition. Immune abnormalities in the children of Third-World countries, where parasitic infestation abounds and poor hygiene is all too common, are of little relevance to considerations of children of the American middle class, where infection is usually absent. Thus, the two are quite different and should be considered separately.

Several studies of complement levels in individuals with anorexia nervosa have found a decrease in C3,^2-4 and normal C4.^2,3,5 Reductions in alternate-pathway components and control proteins^2,4 have been found as well.

In malnutrition complicated by infection, the most likely . . . [Full Text PDF of this Article]

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