title: [Hypokalemia as the principal symptom of covert vomiting. Clinical and diagnostic aspects].
abstract: In 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.
mesh_terms: D000293:Adolescent; D000328:Adult; D002032:Bulimia / Q000150:complications; D005260:Female; D006801:Humans; D007008:Hypokalemia / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D014839:Vomiting / Q000150:complications*
vernacular_title: Hypokaliämie als Leitsymptom bei verheimlichtem Erbrechen. Klinische und diagnostische Aspekte.