Hypertransaminasemia and anemia in anorexia: a chinese box diagnosis!
Teresa Capriati1, Francesca Ferretti1, Antonella Mosca2, Giulia Bolasco1 e Antonella Diamanti1
1U.O.C. Gastroenterologia e Riabilitazione Nutrizionale, Ospedale Pediatrico Bambino Gesù, Roma 2U.O.S. Epatogastroenterologia e Nutrizione, Ospedale Pediatrico Bambino Gesù, Roma
A 16 years old girl, already diagnosed with eating disorder, was admitted for fever, refusal of food and weight loss, asthenia and pharyngodynia. At the exams: anemia (Hb 8.7 g / dL), increase in inflammation indexes (PCR 8.61) and LDH (422 IU / L), moderate hypertransaminasemia (AST 133 IU / L, ALT 272 IU / L) with GGT (214 IU / L) in the absence of alterations in hepatic synthesis function. There were also signs of dehydration with rise in uric acid (6.9 mg / dL), BUN (21 mg / dL) and creatinine (1.8 mg / dL) and decreased clearance (up to 50 ml / min); in the medical history he had taken 2 doses of ibuprofen. This case is an example of diagnoses linked like to Chinese boxes.