Sakurai-Chin Chanhyok, Ito Nobuaki, Taguchi Manabu, Miyakawa Megumi, Takeshita Akira, Takeuchi Yasuhiro
Toranomon Hospital Endocrine Center, Tokyo.
Intern Med. 2010;49(15):1553-6. doi: 10.2169/internalmedicine.49.3373. Epub 2010 Aug 2.
A 33-year-old woman with anorexia nervosa was admitted because of severe malnutrition. Acute liver injury was observed soon after the beginning of oral intake. She was prohibited from eating for 10 days and treated with parenteral nutrition until liver dysfunction was improved. One week after resuming oral intake, she presented severe hypoglycemic coma along with acute exacerbation of hepatocytic injury. Clinical laboratory data suggest that insufficient gluconeogenesis in acute liver injury was involved in severe hypoglycemia. We should be careful of severe hypoglycemia in patients with anorexia nervosa after resuming oral ingestion when signs of liver damage are detected, although hypoglycemic coma is uncommon in anorexia nervosa.
一名33岁的神经性厌食症女性因严重营养不良入院。开始经口摄入食物后不久便观察到急性肝损伤。她被禁食10天，并接受肠外营养治疗，直至肝功能改善。恢复经口摄入食物一周后，她出现严重低血糖昏迷，同时肝细胞损伤急性加重。临床实验室数据表明，急性肝损伤时糖异生不足与严重低血糖有关。尽管低血糖昏迷在神经性厌食症中并不常见，但当检测到肝损伤迹象时，我们在神经性厌食症患者恢复经口进食后应警惕严重低血糖。
