Unintentional thyrotoxicosis factitia due to a diet pill.

Addendum Since the preparation of this manuscript, two additional cases of ipecac myopathy occurring in patients with major eating disorders have been reported."1 Muscle biopsy was done in one patient and showed isolated necrotic fibers, amorphous eosinophilic inclusions in type 1 fibers and no inflammatory response. These cases further support the notion that in patients with binge-purge eating behavior, myopathy may develop from surreptitious ingestion of ipecac and that muscle biopsy may be useful in the diagnosis.