Liver Unit, Queen Elizabeth Hospital, Birmingham, United Kingdom.
Int J Eat Disord. 2010 Dec;43(8):770-2. doi: 10.1002/eat.20775.
Anorexia nervosa (AN) is an eating disorder predominantly affecting young women. Abnormal liver function tests (LFT's) resulting from AN is well-described but to date few cases of dramatic rises in liver enzymes have been described. We report a 32-year-old women with severe anorexia having dramatic rise in LFT's with liver failure during extremely poor nutritional status. Acute rise in liver enzymes observed on several occasions in this patient resulted from ischaemic hepatitis secondary to liver hypoperfusion. Clinicians caring for patients with severe AN should monitor haemodynamic parameters with the knowledge that acute liver failure can be a consequence of sudden liver hypoperfusion. Therapeutic intervention comprising volume support with gradual nutritional support results in normalization of LFT's.
神经性厌食症（AN）主要影响年轻女性，是一种饮食失调症。由 AN 引起的肝功能异常测试（LFT）已有相关描述，但迄今为止，描述剧烈肝酶升高的病例很少。我们报告了一例患有严重厌食症的 32 岁女性，在营养极度不良的情况下，LFT 显著升高，出现肝衰竭。在这名患者身上，多次观察到的肝酶急性升高是继发于肝灌注不足的缺血性肝炎所致。治疗严重 AN 的临床医生应监测血流动力学参数，了解急性肝衰竭可能是突然肝灌注不足的结果。包括容量支持和逐渐营养支持的治疗干预可使 LFT 恢复正常。
