Deranged Liver Function Tests and Liver Insults in Malnourished Patients: A Report of Two Cases and Literature Review

Anorexia nervosa (AN) is an eating disorder often accompanied by complicated medical conditions. It often results in increased serum levels of liver enzymes, especially transaminases, and affects both males and females. Here, we describe the cases of two patients admitted to our District General Hospital. The patients presented with malnourishment secondary to AN and severely deranged liver function tests. According to our literature review, patients who are malnourished are particularly susceptible to liver injury, and small insults can amount to exaggerated liver inflammation with transaminitis. Once other aetiologies are excluded, this can be interpreted as a benign clinical event and is not associated with adverse events or higher mortality.