Life-threatening tonsil hyperplasia probably induced by severe bulimia nervosa: A case report

Method: A case of life-threatening tonsil hyperplasia probably induced by s evere bulimia nervosa is reported. A 14-year-old obese Caucasian girl devel oped severe dyspnea caused by an enlarged hyperplastic lingual tonsil after referral to a child and adolescent psychiatry unit after a sucide attempt during a family conflict. The enlargement of the lingual tonsil was seen 6 months after the development of severe bulimia nervosa. Surgical extirpatio n of the hyperplastic tissue was-done without complications; Hyperplasia of lymphatic tissue associated with bulimia nervosa has never been described before. Results and Discussion: There was no atopic or infectious history i n this case. Presumably, excessive vomiting led to extreme tonsillar growth by irritating the lymphocyte tissue. The relationship between bulimia nerv osa and tonsil hyperplasia is far from clear. Further clinical observations are necessary. (C) 2000 by John Wiley & Sons, Inc.