A case of probable adrenal insufficiency (glucocorticoid only) with hematologic changes including eosinophilia, neutropenia, and red blood cell abnormalities developed in the course of prolonged, fat-free feeding. The coincident development of essential fatty acid deficiency was confirmed by serum fatty acid profiles indicating the presence of abnormal amounts of eicosatrienoic acid, and a triene/tetraene ratio >0.4; all these findings responded to fat repletion. The association of glucocorticoid deficiency, neutropenia, and eosinophilia with essential fatty acid deficiency has not been previously reported in humans.
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