Proton Pump Inhibition in the Management of Hypokalemia in Anorexia Nervosa with Self-Induced Vomiting
| Autor: | Arden Azim, Natalie Jane Wainwright, John Neary |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
020205 medical informatics business.industry 02 engineering and technology General Medicine Gastroenterology Hypokalemia 03 medical and health sciences 0302 clinical medicine Anorexia nervosa (differential diagnoses) Internal medicine 0202 electrical engineering electronic engineering information engineering Medicine Self-induced vomiting 030211 gastroenterology & hepatology medicine.symptom business |
| Zdroj: | Canadian Journal of General Internal Medicine. 13:35-38 |
| ISSN: | 2369-1778 1911-1606 |
| DOI: | 10.22374/cjgim.v13i3.255 |
| Popis: | Hypokalaemia is a dangerous complication in severe cases of eating disorders with self-induced vomiting and can result in rhabdomyolysis, cardiac arrhythmias, and death. Self-induced vomiting leads to hypokalaemia through two pathways. First, loss of gastric acid causes hypochloraemic metabolic alkalosis, which increases filtered bicarbonate load in the nephron (exceeding the tubular resorptive threshold), and subsequently increases distal sodium bicarbonate delivery. Secondly, hypovolaemia causes activation of the renin-angiotensin-aldosterone axis. Increased distal sodium delivery and mineralocorticoid activity together cause urinary potassium wasting. Standard management of severe hypokalaemia in patients with anorexia or bulimia nervosa and persistent self-induced vomiting includes intravenous replacement of potassium and correction of hypovolaemia. However, hypokalaemia is often refractory in eating disorder outpatients who have ongoing self-induced vomiting after discharge. We present a case of hypokalaemia due to anorexia nervosa, binge-purge subtype with self-induced vomiting successfully treated with a proton pump inhibitor (PPI) in addition to standard therapy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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