• Dtsch. Med. Wochenschr. · Jun 1987

    [Hypokalemia as the principal symptom of covert vomiting. Clinical and diagnostic aspects].

    • M Kunz-Kostomanolakis, D Walb, S Abdelhamid, P Fiegel, and A Röckel.
    • Dtsch. Med. Wochenschr. 1987 Jun 19;112(25):1000-5.

    AbstractIn ten adults (nine females), referred for hypokalemia as the cardinal symptom of uncertain etiology and normal blood pressure, surreptitious self-induced vomiting was demonstrated as the main cause. In the majority of such patients, the pathognomonic pattern of serum and urine electrolytes (in the unstable phase--loss of gastric juice) allows diagnosis without hospitalization. If there are atypical urinary electrolyte values or the patients deny vomiting, hospitalization or part-hospitalization is recommended, with parenteral administration of 1 litre physiological saline daily under weight control, and (if necessary) toxicological urine tests for diuretics if there is a high urinary chloride level. In this manner a sufficiently accurate diagnosis is possible.

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