Acute liver injury and anorexia nervosa: a case report

  • Simona Pascolini Department of Medical and Surgical Sciences, Bologna University; Internal Medicine Area of Emergency Department, Sant’Orsola-Malpighi Hospital, Bologna, Italy.
  • Michele Cevolani | michele.cevolani2@gmail.com Department of Medical and Surgical Sciences, Bologna University; Internal Medicine Area of Emergency Department, Sant’Orsola-Malpighi Hospital, Bologna, Italy.
  • Federico Lari Department of Internal Medicine, Hospital of San Giovanni in Persiceto (BO), Italy.
  • Luigi Muratori Department of Medical and Surgical Sciences, Bologna University; Internal Medicine Area of Emergency Department, Sant’Orsola-Malpighi Hospital, Bologna, Italy.
  • Marco Lenzi Department of Medical and Surgical Sciences, Bologna University; Internal Medicine Area of Emergency Department, Sant’Orsola-Malpighi Hospital, Bologna, Italy.

Abstract

Anorexia nervosa is an eating disorder characterized by restriction of energy intake leading to a significant decrease in body weight. While it is primarily a psychiatric disorder, numerous medical complications can occur. In this article we describe a case of a 25-year-old woman with a 12-year history of severe restrictive anorexia nervosa that was referred to the Emergency Service of our Hospital, transferred from a psychiatric institute, for severe weight loss, dehydration, and progressive increase in transaminases. During the hospital stay she developed an acute liver injury with an increase in transaminase level up to 40× the ULN. Infective and immunological causes of acute hepatitis were excluded. In the suspect of severe starvation acute liver injury, we performed a nutritional assessment and started parenteral nutrition. After 15 days of parenteral nutrition, she gained 2.5 kg of body weight and liver tests were drastically reduced and nearly normal.

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Published
2019-06-18
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Section
Case Reports
Keywords:
Anorexia nervosa, malnutrition, acute liver injury, elevated liver enzymes.
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How to Cite
Pascolini, S., Cevolani, M., Lari, F., Muratori, L., & Lenzi, M. (2019). Acute liver injury and anorexia nervosa: a case report. Italian Journal of Medicine, 13(2), 128-131. https://doi.org/10.4081/itjm.2019.1135