title: Laboratory screening for electrolyte abnormalities and anemia in bulimia nervosa: a controlled study.
abstract: OBJECTIVE
  Abnormal eating patterns and recurrent purging behaviors can result in significant medical complications. The purpose of this study was to assess the frequency of abnormalities in clinical laboratory tests in patients with bulimia nervosa who reported being otherwise in good health.
  
  
  METHODS
  Subjects included nonhospitalized women (N = 74) who met criteria for bulimia nervosa outlined in the 3rd Rev. ed. of the Diagnostic and Statistical Manual of Mental Disorders. They also reported use of self-induced vomiting and/or laxatives as compensatory behaviors (purging subtype). The control group (N = 110) included female volunteers with no history of a psychiatric disorder. All subjects reported being in good medical health, were medication free, and were in a normal weight range. Blood samples were analyzed in the hospital clinical laboratory.
  
  
  RESULTS
  Compared with controls, patients showed more frequent occurrence of low values for serum potassium (6.8% vs. 0.9%; p <.05) and chloride (8.1% vs. 0.9%; p <.02). Electrolyte abnormalities occurred most often in patients with frequent bulimic episodes. Study groups did not differ significantly in frequency of abnormal hemoglobin concentrations.
  
  
  CONCLUSIONS
  These results help to clarify the expected frequency of electrolyte abnormalities in individuals with bulimia nervosa who report otherwise good medical health. The substantial frequency of hypokalemia and hypochloremia underscores the importance of an appropriate medical assessment for individuals with this disorder.
authors.affiliation: Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts 02215, USA. bwolfe@caregroup.harvard.edu
authors.forename: B E
authors.initials: BE
authors.lastname: Wolfe
authors.forename: E D
authors.initials: ED
authors.lastname: Metzger
authors.forename: J M
authors.initials: JM
authors.lastname: Levine
authors.forename: D C
authors.initials: DC
authors.lastname: Jimerson
mesh_terms: D000328:Adult; D002032:Bulimia / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D006304:Health Status; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008403:Mass Screening; D015995:Prevalence; D014883:Water-Electrolyte Imbalance / Q000453:epidemiology / Q000209:etiology*
chemical_list: D006454:Hemoglobins