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Biochemical evaluation showed a marked increase in serum levels of aspartate aminotransferases (AST = 9,980 IU\/L), alanine aminotransferase (ALT = 3,930 IU\/L), amylase (1,002 IU\/L), lipase (1,437 IU\/L), creatine phosphokinase (CPK; 783 IU\/L), and lactate dehydrogenase (LDH = 6,830 IU\/L). Glomerular filtration rate was reduced (35 ml\/min), reflecting dehydration and prerenal azotemia. No other cause of acute liver damage except malnutrition was evidenced. Hydration and nutritional support were the unique medical treatment. A rapid recovery occurred in few days and all laboratory data were normal at discharge after a 37\u2010day hospitalization. \u00a9 2004 by Wiley Periodicals, Inc. 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