title: Life-threatening tonsil hyperplasia probably induced by severe bulimia nervosa: a case report.
abstract: METHODS
  A case of life-threatening tonsil hyperplasia probably induced by severe bulimia nervosa is reported. A 14-year-old obese Caucasian girl developed severe dyspnea caused by an enlarged hyperplastic lingual tonsil after referral to a child and adolescent psychiatry unit after a suicide attempt during a family conflict. The enlargement of the lingual tonsil was seen 6 months after the development of severe bulimia nervosa. Surgical extirpation of the hyperplastic tissue was done without complications. Hyperplasia of lymphatic tissue associated with bulimia nervosa has never been described before.
  
  
  CONCLUSIONS
  There was no atopic or infectious history in this case. Presumably, excessive vomiting led to extreme tonsillar growth by irritating the lymphocyte tissue. The relationship between bulimia nervosa and tonsil hyperplasia is far from clear. Further clinical observations are necessary.
authors.affiliation: Hospital "Mutterhaus der Borromäerinnen," Department of Child and Adolescent Psychiatry/Center for Psychobiological and Psychosomatic Research, University of Trier, Trier, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Göpel
authors.forename: F
authors.initials: F
authors.lastname: Herrmann
authors.forename: A
authors.initials: A
authors.lastname: Marcus
mesh_terms: D000293:Adolescent; D000402:Airway Obstruction / Q000209:etiology* / Q000523:psychology; D002032:Bulimia / Q000150:complications* / Q000523:psychology; D005260:Female; D006801:Humans; D006965:Hyperplasia; D014066:Palatine Tonsil / Q000473:pathology*; D013406:Suicide, Attempted / Q000523:psychology; D014839:Vomiting / Q000150:complications / Q000523:psychology