Journal of Investigative Medicine High Impact Case Reports (Jun 2023)

A Case of Abnormal Liver Function Tests in a Patient Receiving Total Parenteral Nutrition

  • Tram Tran CNP,
  • Daniel Sungku Rim MD,
  • Eric Nolen-Doerr MD,
  • Maryellen Lopez RD,
  • Youngdoh Nah,
  • Kavita Sharma MD,
  • Jeong-Hun Shin MD, PhD,
  • Dong Wook Kim MD

DOI
https://doi.org/10.1177/23247096231181969
Journal volume & issue
Vol. 11

Abstract

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Hepatic dysfunction is prevalent in patients receiving total parenteral nutrition (TPN), resulting from steatosis, cholestasis, and cholecystitis. Regular assessments and monitoring of TPN patients are essential, even for clinically stable patients on long-term TPN. Furthermore, it is crucial to establish a differential diagnosis for hepatic dysfunction and investigate for other possible causes of elevated liver enzymes and underlying liver conditions. We present the case of a 56-year-old female patient with severe protein-calorie malnutrition on TPN, who exhibited significantly elevated liver enzymes during the routine periodic assessment. Subsequent investigation revealed that the patient had been taking traditional Chinese herbal medications concurrently with TPN. After discontinuing the herbal medications, the patient’s liver enzymes returned to normal levels within 3 weeks.