[Severe toxic liver injury after overdosage of parenteral administered carbohydrates: a case report (author's transl)].

A 31-year old female patient with anorexia nervosa developed a severe toxic liver injury after parenteral hyperalimentation. Over a period of five days she received a total amount of carbohydrates of 0.47-1.07 g/kg/hr consisting of glucose, fructose and the polyalcohols sorbitol and xylitol. A steep rise in SGOT, SGPT, and GLDH were noted as well as prolongation of the prothrombin time and decrease of the clotting factors; uric acid and lactate increased, serum phosphate decreased. After termination of parenteral hyperalimentation a laparoscopy and liver biopsy were performed. The liver biopsy revealed by light- and electronmicroscopy signs of a severe toxic liver injury. After reduction of total carbohydrates and later oral feeding a complete remission occurred. The cause of the toxic liver lesions was believed to be due to an overdosage of fructose and sorbitol.