High Alert For Cannabinoid Hyperemesis Syndrome: A Case Report
Keywords:Cannabinoids, Vomiting, Baths, Compulsive Behavior
Background: A 32-year-old Caucasian man presented with intractable nausea, psychogenic vomiting, abdominal pain and compulsive hot-water bathing behaviors following the habitual use of cannabis for years, consistent with the uncommon and frequently overlooked diagnosis of Cannabinoid Hyperemesis Syndrome. This was his third admission to the emergency department with the same complaints and symptoms which had persisted for over two years without a recognizable etiology. All imaging studies done on each visit were unremarkable.n
Results: The patient was clinically symptomatic with the aforementioned presenting complaints, but disappeared upon discontinuation of the cannabis. Within two days of supportive treatment in addition to temporary relief of symptoms with bathing. To date, noeffective cure has been sought for this unique diagnosis other than abstaining from cannabis use.
Conclusion: A complete recovery was made three days following admission. The presenting symptoms were attributed to the smoking behaviors. The patient was followed up by his primary care physician once released from the hospital. A very rare diagnosis surfaced a number of times with the same patient in the same setting over the span of a couple years, but was overlooked due to its rarity. Hence, physicians should list it higher on their
differentials when dealing with a patient with a history of drug abuse.
2. Simonetto DA, Oxentenko AS, Herman ML, Szostek JH. Cannabinoid hype¬remesis: a case series of 98 patients. Mayo Clin Proc. 2012 Feb;87(2):114-9.
3. Venkatesan T, Tarbell S, Adams K, McKanry J, Barribeau T, Beckmann K, et al. A survey of emergency department use in patients with cyclic vomiting syndrome. BMC Emerg Med. 2010 Feb 24;10:4.
4. Darmani NA. Cannabinoid-Induced Hyperemesis: A Conundrum—From Clinical Recognition to Basic Science Mechanisms. Pharmaceuticals. 2011 Jul;3(7):2163-77.
5. Harvey DJ, Brown NK. Comparative in vitro metabolism of the cannabi¬noids. Pharmacol Biochem Behav. 1991 Nov;40(3):533-40.
6. Sullivan S. Cannabinoid hyperemesis. Can J Gastroenterol. 2010 May;24(5):284-5.
7. Chang YH, Windish DM. Cannabinoid hyperemesis relieved by compulsive bathing. May Clin Proc. 2009;84(1):76-8.
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