PDF(Pubmed)
Abstract：
Anorexia nervosa (AN) has a high mortality rate due to the widespread organ dysfunction caused by the underlying severe malnutrition. Malnutrition-induced hepatitis is common among individuals with AN especially as body mass index decreases, while acute liver failure and aplastic crisis related to coagulation disease and encephalopathy rarely occur in AN patients. The supervised increase of caloric intake can quickly improve the elevated aminotransferases caused by starvation and aplastic crisis. This current case report describes a 12-year-old adolescent girl who was admitted with a 3-month history of weight loss. Within 3 months, she had lost 10 kg of weight. The girl was diagnosed with AN, acute liver failure, severe malnutrition with emaciation, electrolyte disorder, bradycardia and aplastic crisis. She was gradually supplemented with vitamins and enteral nutrition to avoid refeeding syndrome. After treatment, her liver function and haematopoietic function returned to normal. In conclusion, acute liver failure and aplastic crisis are rare but potentially life-threatening complications of AN, which could be improved by supervised feeding and timely rehydration. AN should be considered as the potential aetiology of acute liver failure and aplastic crisis.
摘要：
由于潜在的严重营养不良引起的广泛的器官功能障碍，神经性厌食症（AN）的死亡率很高。营养不良性肝炎在AN患者中很常见，尤其是随着体重指数降低，而与凝血疾病和脑病相关的急性肝功能衰竭和再生障碍性危机在AN患者中很少发生。有监督地增加热量摄入可以迅速改善由饥饿和再生障碍性疾病引起的转氨酶升高。目前的病例报告描述了一名12岁的青春期女孩，她因3个月的减肥史而入院。3个月内,她瘦了10公斤。那个女孩被诊断为AN,急性肝功能衰竭,严重的营养不良和消瘦，电解质紊乱，心动过缓和再生障碍性危机.她逐渐补充维生素和肠内营养，以避免再喂养综合征。治疗后,肝功能和造血功能恢复正常.总之,急性肝功能衰竭和再生障碍性危机是罕见的，但可能危及生命的并发症，可以通过监督喂养和及时补液来改善。应将AN视为急性肝功能衰竭和再生障碍性危机的潜在病因。
