Clinical Manifestations of Liver Dysfunction in Patients With Anorexia Nervosa

BACKGROUND AND AIMS: The number of Japanese patients with anorexia nervosa (AN) is increasing as society changes. Mild liver dysfunction is a complication of AN in around 30% of cases. In some rare instances, patients present with severe liver dysfunction similar to acute liver failure. However, there are numerous uncertainties over the clinical characteristics of this condition. The objective of the present study was to clarify the clinical characteristics of AN complicated by liver dysfunction and to investigate the factors related to hepatic complications. METHODS: Thirty-seven patients hospitalized at our institution with a diagnosis of AN were enrolled, and clinical data were obtained at the time of hospitalization. Subjects were categorized into three groups: 1) normal liver function, 2) moderate liver dysfunction, and 3) severe liver dysfunction. Subsequently, subgroup analysis was performed. RESULTS: All study subjects were female with an average age of 26 years and presenting with marked weight loss (mean body mass index, 13 kg/m). Thirteen subjects were found to have liver dysfunction. Patients with severe liver dysfunction (alanine aminotransferase >800IU/L) had a significantly higher level of blood urea nitrogen (BUN) and a higher BUN/creatinine ratio, and a lower body temperature and blood sugar level, compared with patients with normal liver function. CONCLUSIONS: Our present findings indicate that AN patients with severe liver dysfunction have a high degree of dehydration. This suggests that dysfunction of the hepatic circulation accompanying severe dehydration due to malnutrition, may be an important factor in the development of severe liver dysfunction in AN patients.