title: [Severe toxic liver injury after overdosage of parenteral administered carbohydrates: a case report (author's transl)].
abstract: A 31-year old female patient with anorexia nervosa developed a severe toxic liver injury after parenteral hyperalimentation. Over a period of five days she received a total amount of carbohydrates of 0.47-1.07 g/kg/hr consisting of glucose, fructose and the polyalcohols sorbitol and xylitol. A steep rise in SGOT, SGPT, and GLDH were noted as well as prolongation of the prothrombin time and decrease of the clotting factors; uric acid and lactate increased, serum phosphate decreased. After termination of parenteral hyperalimentation a laparoscopy and liver biopsy were performed. The liver biopsy revealed by light- and electronmicroscopy signs of a severe toxic liver injury. After reduction of total carbohydrates and later oral feeding a complete remission occurred. The cause of the toxic liver lesions was believed to be due to an overdosage of fructose and sorbitol.
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000178:diet therapy; D001706:Biopsy; D056486:Chemical and Drug Induced Liver Injury; D005260:Female; D005632:Fructose / Q000009:adverse effects; D005947:Glucose / Q000009:adverse effects; D006601:Hexoses / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D008099:Liver / Q000473:pathology; D008107:Liver Diseases / Q000473:pathology; D010288:Parenteral Nutrition; D013012:Sorbitol / Q000009:adverse effects; D013402:Sugar Alcohols / Q000008:administration & dosage / Q000009:adverse effects*; D014993:Xylitol / Q000009:adverse effects
chemical_list: D006601:Hexoses; D013402:Sugar Alcohols; D005632:Fructose; D013012:Sorbitol; D005947:Glucose; D014993:Xylitol
vernacular_title: Schwere toxische Leberschädigung nach Uberdosierung von parenteral verabreichten Kohlenhydraten