Introduction: Anorexia nervosa is associated with a vast amount of general medical complications caused by severe weight loss and malnutrition. Common complications from affected organ systems lead to many physiologic disturbances and multi-organ complications, but rarely severe transaminitis or iron deposition. We discuss a case report of severe transaminitis and iron deposition in a patient with anorexia nervosa.

Case: 31 year old male presents to the ED with a history of altered mental status and found to have severe transaminitis. Introduction of nutrition lead to a quick downtrend in liver transaminases with eventual normalization. Additionally, iron deposition as seen in the liver of our patient.

Discussion: Severely elevated transaminitis has been a rare complication of anorexia nervosa. Starvation induced autophagy has been a proposed mechanism. There has been one case report of hepatic iron deposition in a patient with anorexia nervosa. Iron deposition has been seen in starved mice livers with gluconeogenesis and alteration in iron homeostasis possibly playing a role.