ELEVATION OF SERUM AMINOTRANSFERASE AS A SIGN OF MULTIORGAN-DISORDERSIN SEVERELY EMACIATED ANOREXIA-NERVOSA

To clarify the clinical significance of elevation of serum aminotransf erase levels in anorexia nervosa, we analyzed the relationships of ser um aminotransferase levels to other serum biochemistry and physical co nditions before and during refeeding therapy in 101 patients with anor exia nervosa. Before refeeding therapy, body mass index (BMI) was dist ributed from 9.9 to 16.4 kg/m(2) (13.2+/-1.3, mean+/-SD), and 29 patie nts (28.7%) showed abnormally high aminotransferase levels, Among 17 p atients with a BMI of less than 12 kg/m(2), the aminotransferase level was abnormally high in 13 patients (76%), Incidence and severity of s erum aminotransferase elevation were greater in the patients with lowe r BMI, The groups with high serum aminotransferase levels had a lower body temperature, lower pulse rate, and higher incidence of other bioc hemical abnormalities than the group with normal serum aminotransferas e levels, These findings indicate that aminotransferase elevation deve lops at a high incidence in anorectic patients with a critically life- threatening condition, and it is a sign of multiorgan failure requirin g urgent calorie repletion, This type of aminotransferase elevation is to be distinguished from refeeding-induced aminotransferase elevation .