title: Anorexia nervosa with severe liver dysfunction and subsequent critical complications.
abstract: A twenty-year-old woman with anorexia nervosa (body mass index=11) suffered from severe liver dysfunction (aspartate aminotransferase 5,000 IU/l, alanine aminotransferase 3,980 IU/l, prothrombin time 32%), hypoglycemia (serum glucose 27 mg/dl), and pancreatic dysfunction (amylase 820 IU/l, lipase 558 IU/l). She fell into a depressive state with irritability, which was not improved by intravenous glucose. Despite treatment with plasmapheresis for the liver dysfunction, she subsequently developed pulmonary edema, acute renal failure, gastrointestinal bleeding, and disseminated intravascular coagulation. Hemodialysis, mechanical ventilation and drug therapy including prednisolone, prostaglandin E1, and branched-chain amino acid, improved her critical condition. In this case, malnutrition may have been the cause for the liver dysfunction and subsequent complications.
authors.affiliation: Department of Internal Medicine, National Okura Hospital, Tokyo.
authors.forename: S
authors.initials: S
authors.lastname: Furuta
authors.forename: Y
authors.initials: Y
authors.lastname: Ozawa
authors.forename: K
authors.initials: K
authors.lastname: Maejima
authors.forename: H
authors.initials: H
authors.lastname: Tashiro
authors.forename: T
authors.initials: T
authors.lastname: Kitahora
authors.forename: K
authors.initials: K
authors.lastname: Hasegawa
authors.forename: S
authors.initials: S
authors.lastname: Kuroda
authors.forename: N
authors.initials: N
authors.lastname: Ikuta
mesh_terms: D058186:Acute Kidney Injury / Q000150:complications; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000856:Anorexia Nervosa / Q000150:complications*; D001219:Aspartate Aminotransferases / Q000097:blood; D016638:Critical Illness; D004211:Disseminated Intravascular Coagulation / Q000150:complications; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000150:complications; D006801:Humans; D007003:Hypoglycemia / Q000150:complications; D017114:Liver Failure, Acute / Q000150:complications* / Q000209:etiology / Q000628:therapy; D009748:Nutrition Disorders / Q000150:complications; D011654:Pulmonary Edema / Q000150:complications
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase