Acute Liver Damage and Anorexia Nervosa: A Case Report and Review of the Literature

Abstract

We treated a patient suffering from severe anorexia nervosa [body mass index (BMI), 10.5 kg/m²] complicated with hepatic insufficiency. The treatment consisted of rehydration and the correction of her malnutrition, using adapted protocols to avoid the development of the refeeding syndrome. In view of her successful progress she was discharged from the hospital on day 50. Although we do not perform a hepatic biopsy, the mechanism seems to be related to autophagy more than hypoperfusion because of the extremely low BMI. This observation also highlights the need of following a multidisciplinary approach in these difficult cases (BMI < 13 kg/m²), involving intensive care unit doctors, gastroenterologists, endocrinologists and psychiatrists.