Two cases of anorexia nervosa associated with grossly abnormal liver function tests.

Yamagata, Akio; Hirose, Shoichiro; Wakakuri, Nobuto; Honjou, Hideo; Nakagawa, Hidetoshi; Nishimura, Kazunari; Kubo, Tadashi

doi:10.2169/naika.78.563

Cited by 3 publications

(1 citation statement)

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“…In some reports, the term 'transaminitis' is used [1, 3,21], but this is not associated with any pathogenetic concept. With the term 'hepatitis', which has been used by some other authors [12,17,22], a definition is made at least of what is to be expected in histology: histologically, hepatitis is characterised by single-cell necrosis. There is oedema of the portal fields and a portal infiltrate by lymphocytes, histiocytes and a few plasma cells.…”

Section: Introductionmentioning

confidence: 99%

Liver Damage Is Related to the Degree of Being Underweight in Anorexia Nervosa and Improves Rapidly with Weight Gain

Cuntz

Voderholzer

2022

Nutrients

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Background: The present study investigates the relationship between hypertransaminasemia and malnutrition on the basis of a very large number of patients. We assume that the level of transaminases not only reflects the extent of underlying liver cell damage but also provides information about the metabolic situation under conditions of energy deficiency. Methods: We present an observational study in two different samples. The first sample consists of 3755 patients (mean age 22.7 years, Range 12–73 years; mean BMI 15.4 kg/m2, range 8.1–25.7) out of a total of 4212 patients with anorexia nervosa treated in the Roseneck Clinic within five years for whom a complete admission laboratory was available. The second sample was obtained from a special ward for medically at-risk patients with eating disorders. During the period in question, four hundred and ten patients with anorexia nervosa were treated. One hundred and forty-two female patients (mean age 26.4 years, Range 18–63 years; mean BMI 11.5 kg/m2, range 8.4–13) had a BMI of thirteen or less and a complete data set was obtained at admission and weekly in the following four weeks after admission. Results: The increase in liver transaminases shows a very high correlation with weight in sample one (N = 3755). The analysis of variance shows highly significant (<0.001) correlations with an F-value of 55 for GOT/AST and 63 for GPT/ALT. Nevertheless, the variance within the groups with the same BMI is quite high. With re-nutrition in sample two, GOT/AST decreased on average from 71 U/L to 26 U/L (MANOVA F 10.7, p < 0.001) and GPT/ALT from 88 to 41 U/L (F = 9.9, p < 0.001) within four weeks. Discussion: Below a BMI of about 13, the nutritional status of the patients becomes so critical that the energy supply of the patient is increasingly dependent on the autophagy of the liver, which can be seen in the very strong increase in transaminases here. Refeeding leads very quickly to the normalisation of the transaminases and, thus, a stabilisation of the metabolism leading also to a decrease in autophagy.

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Section: Introductionmentioning

confidence: 99%

Liver Damage Is Related to the Degree of Being Underweight in Anorexia Nervosa and Improves Rapidly with Weight Gain

Cuntz

Voderholzer

2022

Nutrients

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Abnormalities of liver function in severe anorexia nervosa

Jones

Pieri

Losowsky

1999

Eur. Eat. Disorders Rev.

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This pilot study investigated the frequency, cause and progress of abnormal liver function tests (LFTs) in severe anorexia nervosa. Six consecutive cases of anorexia nervosa severe enough to require hospital admission and 14 outpatients with anorexia nervosa had LFTs performed. All inpatients had abnormal LFTs, with grossly elevated liver enzymes in four patients. All normalized quickly with weight gain apart from one whose alanine transaminase (ALT) remained slightly elevated. Investigations failed to reveal any other cause of liver disease. ALT values were slightly elevated in three outpatients. Abnormal LFTs occur in some patients with anorexia nervosa. Most resolve quickly and are not associated with hepatic failure. A larger study is required to determine the frequency of occurrence, cause and natural history.

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