Kunz-Kostomanolakis M, Walb D, Abdelhamid S, Fiegel P, Röckel A
Dtsch Med Wochenschr. 1987 Jun 19;112(25):1000-5. doi: 10.1055/s-2008-1068183.
In ten adults (nine females), referred for hypokalemia as the cardinal symptom of uncertain etiology and normal blood pressure, surreptitious self-induced vomiting was demonstrated as the main cause. In the majority of such patients, the pathognomonic pattern of serum and urine electrolytes (in the unstable phase--loss of gastric juice) allows diagnosis without hospitalization. If there are atypical urinary electrolyte values or the patients deny vomiting, hospitalization or part-hospitalization is recommended, with parenteral administration of 1 litre physiological saline daily under weight control, and (if necessary) toxicological urine tests for diuretics if there is a high urinary chloride level. In this manner a sufficiently accurate diagnosis is possible.
在10名成年人（9名女性）中，以不明病因的低钾血症为主要症状且血压正常，经证实主要病因是隐匿性自我诱导呕吐。在大多数此类患者中，血清和尿液电解质的特征性模式（在不稳定阶段——胃液丢失）可在不住院的情况下进行诊断。如果存在非典型的尿液电解质值或患者否认呕吐，建议住院或部分住院，在体重控制下每天静脉注射1升生理盐水，并且（如有必要）如果尿氯水平高则进行利尿剂的毒理学尿液检测。通过这种方式可以做出足够准确的诊断。
