Eating disorders Nephrocalcinosis associated with diuretic and laxative abuse in anorexia nervosa

Anorexia nervosa is characterized by a weight loss, resulting in body weight that is at least 85% below that of expected normal for a specific age and height, fear of gaining weight and exhibition of a significant disturbance in the perception of the shape and size of own body and amenorrhea. Individuals with anorexia nervosa of binge eating/purging type eat binge and subsequently adopt vomiting or diuretic and/or laxative abuse as compensatory behaviours. To our knowledge, diuretics and laxatives can lead to severe electrolyte disturbances (hypokalemia, hyponatremia, hypocalcemia, hypomagnesemia), nephrolithiasis and alterations in water metabolism. Nephrocalcinosis defined as the deposition of calcium in the kidney results from various metabolic defects such as disturbance of calcium metabolism, renal tubulopathy, medullary sponge kidney and medications. Diuretic related nephrocalcinosis in anorexia nervosa was reported in limited number of cases in the literature. We describe here a case of nephrocalcinosis affected by anorexia nervosa, who abuse furosemide and bisacodyl for a long time. In conclusion, long term furosemide abuse can provoke nephrocalcinosis and thus potential for renal damage needs to be investigated in patients suffering from long-term anorexia nervosa.