Nishioka Hiroaki, Yoshizaki Aisa, Imai Yukihiro, Higashibeppu Naoki
Department of General Internal Medicine, Kobe City Medical Center General Hospital, Japan.
Department of Pathology, Kobe City Medical Center General Hospital, Japan.
Intern Med. 2019 Mar 1;58(5):749-753. doi: 10.2169/internalmedicine.1663-18. Epub 2018 Oct 17.
Exacerbation of liver enzymes after the initiation of feeding in malnourished patients is caused by refeeding syndrome or persistent starvation. There are no definite clinical markers for distinguishing between the two conditions. We herein report a 63-year-old woman with starvation-induced liver enzyme elevation. Her body weight was inversely associated with the liver enzyme levels after refeeding, which was a different course from refeeding syndrome. Normalization of liver enzymes ensued as the caloric intake increased and weight gain progressed. Daily changes in body weight can be a useful clinical marker for distinguishing between refeeding syndrome and starvation-induced liver enzyme elevation.
营养不良患者开始进食后肝酶升高是由再喂养综合征或持续饥饿引起的。目前尚无明确的临床标志物来区分这两种情况。我们在此报告一名63岁因饥饿导致肝酶升高的女性。再喂养后她的体重与肝酶水平呈负相关，这与再喂养综合征的病程不同。随着热量摄入增加和体重增加，肝酶恢复正常。体重的每日变化可能是区分再喂养综合征和饥饿引起的肝酶升高的有用临床标志物。
