Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Elevated transaminases as a predictor of coma in a patient with anorexia nervosa: a case report and review of the literature | Yoshida et al. Journal of Medical Case Reports 2010 4 307 http content 4 1 307 jAg JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Elevated transaminases as a predictor of coma in a patient with anorexia nervosa a case report and review of the literature 13 2 2 3 Shuhei Yoshida 1 Masahiko Shimada 1 Miroslaw Kornek Seong-Jun Kim Katsunosuke Shimada Detlef Schuppan2 Abstract Introduction Liver injury is a frequent complication associated with anorexia nervosa and steatosis of the liver is thought to be the major underlying pathology. However acute hepatic failure with transaminase levels over 1000 lU mL and deep coma are very rare complications and the mechanism of pathogenesis is largely unknown. Case presentation A 37-year-old Japanese woman showed features of acute liver failure and hepatic coma which were not associated with hypoglycemia or hyper-ammonemia. Our patient s consciousness was significantly improved with the recovery of liver function and normalization of transaminase levels after administration of nutritional support. Conclusions Our case report demonstrates that transaminase levels had an inverse relationship with the consciousness of our patient although the pathogenesis of coma remains largely unknown. This indicates that transaminase levels can be one of the key predictors of impending coma in patients with anorexia nervosa. Therefore frequent monitoring of transaminase levels combined with rigorous treatment of the underlying nutritional deficiency and psychiatric disorder are necessary to prevent this severe complication. Introduction Anorexia nervosa AN is a difficult-to-treat psychosomatic disease. Mild liver injury is regularly detected as a complication of AN 1-5 . Although severe acute liver injury has been previously described in a patient with AN the underlying pathogenetic mechanisms remain largely unclear. Furthermore only a few cases of AN with deep coma have been reported mostly due to .
