Hypertransaminasemia in a Woman Diagnosed with Anorexia Nervosa Under Day Hospital Therapeutic Intervention

Abstract

Introduction: Eating Disorder (ED) is one of the central chronic pathologies in adolescents, noted for its high morbidity and mor tality rates. Within the spectrum of EDs, anorexia nervosa presents a high mortality rate due to medical complications or suicide. This disorder, in addition to its psychological impacts, involves physical complications such as alterations in liver enzymes and non alcoholic fatty liver disease, often associated with malnutrition. Materials and Methods: An 18-year-old Caucasian female with a previous history of anorexia nervosa lasting 4 years was referred in January 2021 to the Spiral Therapeutic Center (STC) for a multidisciplinary clinical approach, after being previously hospitalized in the psychiatric unit of the Marina Baixa Regional Hospital during 2020. The therapeutic approach included multidisciplinary treatments spread over two six-month periods, renewable according to the STC protocol, without using enteral or parenteral feeding during her hospital stays. Results: During her treatment, a gradual improvement in transaminase levels and a reduction in signs of hepatic steatosis were ob served. The integration of psychological and nutritional interventions during outpatient treatment allowed for a more effective and sustained recovery, compared to more intensive and less integrated approaches experienced during her previous hospitalizations. Conclusions: The multidisciplinary management of anorexia nervosa, incorporating medical, psychological, and nutritional aspects, proves to be effective when carried out on an outpatient and continuous basis, rather than through acute or sporadic interventions. This approach not only improves biochemical parameters, such as liver transaminases, but also contributes to a better overall recov ery of the patient. Personalization of nutritional and psychological treatment is crucial to effectively address the challenges associ ated with this disorder