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Acute liver damage in anorexia nervosa
Full text linkWe report a case of a 26-year-old White woman with a history of anorexia nervosa who developed severe liver damage and multiorgan dysfunction. At admission to our medical unit, her body mass index (BMI) was 10.8. Biochemical evaluation showed a marked increase in serum levels of aspartate aminotransferases (AST = 9,980 IU/L), alanine aminotransferase (ALT = 3,930 IU/L), amylase (1,002 IU/L), lipase (1,437 IU/L), creatine phosphokinase (CPK; 783 IU/L), and lactate dehydrogenase (LDH = 6,830 IU/L). Glomerular filtration rate was reduced (35 ml/min), reflecting dehydration and prerenal azotemia. No other cause of acute liver damage except malnutrition was evidenced. Hydration and nutritional support were the unique medical treatment. A rapid recovery occurred in few days and all laboratory data were normal at discharge after a 37-day hospitalization
Body mass index and agreement between bioimpedance and anthropometry estimates of body compartments in anorexia nervosa
No full textSodium depletion and hemoconcentration: overlooked complications in patients with anorexia nervosa?
No full textOBJECTIVE:
This study evaluated sodium and fluid balance disturbances in anorexia nervosa.
METHODS:
Serum urea, creatinine, urea nitrogen/creatinine ratio, protein concentration, osmolality, electrolytes, hemoglobin, and hematocrit were evaluated on admission, after intravenous fluid supplementation, and at discharge in 14 patients who had anorexia nervosa and were admitted to a medical unit for severe malnutrition and/or medical complications. Diet history and physical signs of salt and water depletion were also evaluated on admission. The diagnosis of plasma volume depletion was considered confirmed if serum urea nitrogen/creatinine ratio was higher than 25.
RESULTS:
Mean body mass indexes were 12.9 +/- 2.4 kg/m2 on admission and 14.2 +/- 2.0 kg/m2 at discharge. Mean duration of hospitalization was 24.2 +/- 11.9 d. Plasma volume depletion was found on admission in nine patients (64%), and hyponatremia was associated with hypovolemia (hypovolemic hyponatremia) in three of them. Most of the commonly used indexes of hemoconcentration (hematocrit, hemoglobin, serum urea, and creatinine) were normal on admission but decreased significantly after intravenous fluid supplementation and were maintained at lower levels at discharge (P < 0.001, P < 0.0004, P < 0.009, and P < 0.001, respectively, compared with admission values). Hemoconcentration masked an underlying anemia (hemoglobin < 12 g/dL) in six patients. Only two of the nine patients with plasma volume depletion had a history of diuretic abuse, and the other seven patients reported long-term sodium restriction as a method to control body weight.
CONCLUSIONS:
Plasma volume depletion and hypovolemic hyponatremia are common in the most severely malnourished patients with anorexia nervosa. Clinicians should be aware that, because of malnutrition, the common indexes of hemoconcentration may be within normal range and that hemoconcentration may mask anemia. Further studies are needed to assess the role of neglected behaviors such as sodium and fluid restriction
L’ epatite da virus C dopo trapianto di fegato: storia naturale e prospettive di prevenzione e terapia
No full text
SODIUM DEPLETION AND HAEMOCONCENTRATION: OVERLOOKED COMPLICATIONS IN PATIENTS WITH ANOREXIA NERVOSA
No full textTotal serum cholesterol and suicidality in anorexia nervosa
No full textOBJECTIVE:
No published study has evaluated the relationship between serum cholesterol and suicidality in anorexia nervosa (AN).
AIMS:
To assess psychiatric and nutritional correlates of serum cholesterol in a sample of AN patients.
METHODS:
Serum cholesterol and nutritional status were evaluated in a sample of 74 AN patients, before starting any type of refeeding. All subjects underwent a structured clinical interview and completed the Hopkins Symptom Checklist.
RESULTS:
Subjects who reported previous suicide attempts, impulsive self-injurious behavior, or current suicidal ideation showed significantly lower cholesterol levels than subjects without suicidality. Cholesterol levels were negatively correlated with the severity of depressive symptoms in all the patients with the exception of those with recurrent binge eating. A multivariate analysis showed that the relationships between cholesterol levels and suicidal behavior and ideation do not seem to be affected by the nutritional and metabolic factors considered in the study.
CONCLUSIONS:
Notwithstanding the influence of important metabolic factors affecting cholesterolemia in AN, our research tends to confirm previous studies that have found an association between low cholesterol levels and suicidality
Biochemical parameters for the assessment of malnutrition and for monitoring nutrition intervention in anorexia nervosa
No full textAbstract 25th Congress of the European Society of Parenteral and Enteral Nutritio
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