Hepatic autophagy secondary to severe dietary restriction in patients with anorexia nervosa.
DOI:
https://doi.org/10.12873/421gonzalezKeywords:
Anorexia Nervosa; Autophagy; Acute Liver Failure.Abstract
Exceptionally, anorexia nervosa causes severe liver failure due to excessive activation of autophagy.
Retrospective study of several clinical variables and complementary tests of a series of patients with anorexia nervosa who developed acute hepatopathy associated with severe dietary restriction.
Eight patients aged 31.75±7.83 years, with a body mass index of 12.92 kg/m2 were evaluated. Elevated AST and ALT concentrations was the most characteristic feature (AST 780.77±553.47 IU/L; ALT 659.2±558.64 IU/L). In some cases, also hypoglycaemia, coagulopathy and/or thrombopenia were associated. All patients recovered ad integrum in 43.28 ± 15.93 days after receiving adequate dietary treatment (an initial diet of 650 ± 154.11 kcal/day).
Liver autophagy is the main pathogenic mechanism of severe reversible hepatitis in patients with chronic severe anorexia nervosa.
References
Gaby Resmark, Stephan Herpertz BH-D and AZ. Treatment of Anorexia Nervosa-New Evidence-Based Guidelines.pdf. J Clin Med. 2019;388: 1–16.
Steinhausen HC. The outcome of anorexia nervosa in the 20th century. Vol. 159, American Journal of Psychiatry. 2002. p. 1284–93.
World Health Organization (WHO) ICD 11 International Classification of Diseases 11th Revision.
Rosen E, Bakshi N, Watters A, Rosen HR, Mehler PS. Hepatic Complications of Anorexia Nervosa. Dig Dis Sci. 2017;62(11):2977–81.
Furuta S, Ozawa Y, Maejima K, Tashiro H, Kitahora T, Hasegawa K, et al. Anorexia nervosa with severe liver dysfunction and subsequent critical complications. Intern Med. 1999;38(7):575–9.
Baehrecke E. Autophagy: dual roles in life and death? Nat Rev Mol Cell Biol [Internet]. 2005;6: 505–10. Available from: https://doi.org/10.1038/nrm1666
Kheloufi M, Boulanger CM, Durand F, Rautou P. Liver Autophagy in Anorexia Nervosa and Acute Liver Injury. Biomed Res Int. 2014;2014: 1–10.
Imaeda M, Tanaka S, Fujishiro H, Kato S, Ishigami M, Kawano N, et al. Risk factors for elevated liver enzymes during refeeding of severely malnourished patients with eating disorders: A retrospective cohort study. J Eat Disord [Internet]. 2016;4(1):1–10. Available from: http://dx.doi.org/10.1186/s40337-016-0127-x
Bridet L, Jose J, Martin B, Luis J, Nuno C. Acute liver damage and anorexia nervosa: A case report. Turk J Gastroenterol. 2014;25:205–8.
Restellini S, Spahr L, Brandt LR. Severe Starvation-Induced Hepatocyte Autophagy as a Cause of Acute Liver Injury in Anorexia Nervosa: A Case Report. Case Reports Hepatol. 2013;2013: 36–9.
Deegan, S., Saveljeva, S., Gorman AM et al. Stress-induced self-cannibalism: on the regulation of autophagy by endoplasmic reticulum stress. Cell Mol Life Sci [Internet]. 2013;70: 2425–2441. Available from: https://doi.org/10.1007/s00018-012-1173-4
Downloads
Published
How to Cite
License
Copyright (c) 2022 Nutrición Clínica y Dietética Hospitalaria
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Los lectores pueden utilizar los textos publicados de acuerdo con la definición BOAI (Budapest Open Access Initiative)
