A 28-year-old woman manifested a hemorrhagic tendency caused by a deficiency of vitamin K—dependent coagulation factors. Her condition was diagnosed as bulimia nervosa in view of a previous history of anorexia nervosa and episodes of self-induced vomiting and purging. There were no remarkable lesions in her alimentary system. In treatment of bulimia nervosa, attention should be given not only to the loss of body fluids and electrolytes, but also to the possibility of a deficiency of vitamin K—dependent coagulation factors.
Niiya K, Kitagawa T, Fujishita M, et al. Bulimia Nervosa Complicated by Deficiency of Vitamin K—Dependent Coagulation Factors. JAMA. 1983;250(6):792–793. doi:10.1001/jama.1983.03340060070030
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