Anorexia Nervosa (AN) is a complex psychiatric illness, characterized by a high risk of developing cardiovascular complications. Given the high risk of vascular diseases in patients with AN, we can assume that patients with severe AN have a high risk of developing ischemic stroke. However, to the best of our knowledge, no reports of patients with AN presenting with ischemic stroke have been published, other than a report of the development of IS during refeeding therapy in patients with severe AN. The present case report is aimed at describing the characteristics of an ischemic stroke occurring in a 19-year-old university student who had a 6-month history of AN. She was a non-smoker, had no relevant medical history and no family history of stroke. Upon hospital admission due to symptoms of stroke (aphasia and facial droop), she exhibited severe malnutrition with a BMI of 12.8 kg/m2. Computerized tomography imaging revealed occlusion of the left M2 branch and a congruous extensive area of hypoperfusion. Further investigations ruled out all common causes of stroke: she had no vascular stenosis, no heart diseases or arrhythmias, and no shunts, and gave negative results in autoimmune, toxicological and thrombophilia screenings. Clinicians should suspect development of severe complications, including ischemic stroke, in patients with severe AN. Further extensive group studies or group-based studies are needed to elucidate the etiology of ischemic stroke in patients with severe AN. This will enable us to develop more precise and effective interventions.

Thermal injury is known to induce alterations in the immune system, but the precise mechanisms have yet to be elucidated. It has been shown that thermal injury in more than 20% of the total body surface area (TBSA) leads to disturbances in the cortisol metabolism and the equilibrium of the hypothalamic-pituitary-adrenal axis. We investigated the temporal relationship between serum cortisol levels, C-reactive protein, and immunoglobulin levels in the post-burn period. Twenty-one adult burn patients (mean age, 52 ± 17 yrs) were included in the study (TBSA, 10-80%); nine developed sepsis and five died. The nonseptic group consisted of twelve patients. Thirty healthy blood donors served as controls. Our results suggest that increased cortisol and decreased immunoglobulin levels could be related to severe sepsis and clinical outcome.