Een anorexiapatiënt met acute leverproefstoornissen

Background

Anorexia nervosa is associated with somatic complications. Mildly abnormal liver tests are frequently seen; however, severe acute liver injury is rare in anorexia.

Case description

A 23-year-old woman was admitted with acutely elevated liver enzymes and hypoglycemia. All diagnostic tests for acute hepatitis were negative. Therefore, we made the diagnosis of ‘acute liver injury due to anorexia’. With supportive care such as rehydration, drip-feed and infusions with glucose, the patient recovered and her liver tests improved.

Conclusion

Severe acute liver injury is a rare but life-threatening complication of anorexia nervosa. Its aetiology is unknown. Autophagy of hepatocytes, hypoperfusion of the liver and oxidative stress may play a role in the pathogenesis. Treatment consists of rehydration and nutritional support.

Conflict of interest and financial support: disclosure forms provided by the authors are available along with the full text of this article at www.ntvg.nl; search for A6247, click on ‘Belangenverstrengeling’ (‘Conflict of interest’).