Primary Article

Anorexia Nervosa A Disorder With Severe Acid-Base Derangements

Authors: DONALD R. MARS MD, NORMAN H. ANDERSON MD, FRANK C. RIGGALL MD

Abstract

Fluid and electrolyte derangements occur frequently in patients with vomiting and anorexia nervosa and contribute to protracted morbidity and a mortality reported to be as high as 22%, probably from hypokalemia. Hypochloremic, hypokalemic metabolic alkalosis is characteristic, in conjunction with significant intravascular volume depletion and hypotension. Exceedingly low urinary chloride concentrations confirm a shrunken vascular space. Treatment with intravenous isotonic saline or oral salt tablets and fluid will resolve these abnormalities, and the urinary chloride level will be the best guideline of euvolemia.

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References