title: [Diuretic-Abuse in Chronic Bulimia Nervosa--Case Report and Clinical Management].
abstract: We give account of a patient, who works in health care, with bulimia nervosa (BN) and a long term abuse of Furosemide. Due to patients' tendency to conceal addictive behavior and symptoms of BN, the prevalence of purging behavior caused by the intake of diuretics is difficult to quantify 10% of BN patients exhibit a long-term harmful abuse. Discontinuation of diuretics causes the development of edema, attributable to pathophysiological changes with hyperaldosteronism. These can lead to renewed escalation of purging behaviour, provoked either by phobia of weight gain or by unbearable feelings of tension in the facial area or in the legs. For an adequate clinical management, it is vital to have thorough knowledge of the pathophysiological context which consists of psychoeducation, provision of information, treatment of water-electrolyte imbalance and, in individual cases, the administration of aldosterone antagonists.
authors.affiliation: Schön Klinik Roseneck, Psychosomatik, Prien am Chiemsee.
authors.forename: Martin
authors.initials: M
authors.lastname: Greetfeld
authors.affiliation: Schön Klinik Roseneck, Psychosomatik, Prien am Chiemsee.
authors.forename: Nicole
authors.initials: N
authors.lastname: Bröckel-Ristevski
authors.affiliation: Schön Klinik Roseneck, Psychosomatik, Prien am Chiemsee.
authors.forename: Markus
authors.initials: M
authors.lastname: Fumi
authors.affiliation: Schön Klinik Roseneck, Psychosomatik, Prien am Chiemsee.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Cuntz
authors.affiliation: Schön Klinik Roseneck, Psychosomatik, Prien am Chiemsee.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Voderholzer
mesh_terms: D000328:Adult; D052018:Bulimia Nervosa / Q000150:complications* / Q000523:psychology; D002908:Chronic Disease; D004232:Diuretics / Q000009:adverse effects*; D005260:Female; D005665:Furosemide / Q000009:adverse effects; D006801:Humans; D019966:Substance-Related Disorders / Q000150:complications* / Q000523:psychology; D014883:Water-Electrolyte Imbalance / Q000139:chemically induced
chemical_list: D004232:Diuretics; D005665:Furosemide