A case of anorexia nervosa with severely elevated liver enzymes

Shibuki Taro, Kawasoe Hiroaki, Mizuta Toshihiko

doi:10.2957/kanzo.59.647

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Other Title

著明な肝逸脱酵素上昇を来たした神経性食思不振症の1例
症例報告著明な肝逸脱酵素上昇を来たした神経性食思不振症の1例
ショウレイホウコクチョメイナカンイツダツコウソジョウショウオキタシタシンケイセイショクシフシンショウノ 1レイ

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<p>The case patient was a 32-year-old female. At the age of 30 years, her weight started decreasing because of the stress caused by her mother-in-law. After her weight decreased to 26 kg (body mass index, 9.5 kg/m²) in 2 years, she experienced difficulty in moving and was referred to our hospital. Although nutritional interventions were initiated, her liver enzymes gradually worsened. The elevation of liver enzymes was attributable to the development of refeeding syndrome; therefore, we restricted her calorie intake. However, acute elevation of liver enzymes was observed in 4 days. Drop infusion, involving small amounts of carbohydrates immediately lowered her liver enzymes; however, her serum potassium and phosphorous levels dropped, warranting replacement therapy. Thereafter, her liver enzyme levels returned to normal levels, electrolyte balance was restored, and she was transferred to the psychiatric department of another hospital. In recent years, autophagy is attracting attention as the leading cause of elevated liver enzymes in patients with anorexia nervosa. We discussed the etiology underlying elevation of liver enzymes in this patient from the perspective of the clinical course.</p>

Journal

Kanzo

Kanzo 59 (11), 647-652, 2018-11-20

The Japan Society of Hepatology

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