Acute liver injury and anorexia nervosa: a case report

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 40x 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.