Cannabinoid Hyperemesis Syndrome: The Missed Diagnosis

João B. Fonseca, Daniela Vilaverde, R. Rodrigues, P. Morgado
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Abstract

Cannabis is the most cultivated and abused illicit drug worldwide. Paradoxically to the antiemetic properties attributed to cannabis, a relatively new cannabinoid hyperemesis syndrome (CHS) started to be recognized and is characterized by cyclic vomiting that are interspaced by asymptomatic phases. We present a case of a 36‑year‑old woman who repeatedly presented to the emergency room with cyclic vomiting that alleviated with hot showers. She was a long‑term cannabis user and the diagnosis was only established several years later after the onset of symptoms. The diagnostic work up was unremarkable, and the only effective treatment was cannabis cessation. Hot bathing behavior is a key characteristic of this syndrome. CHS is a new clinical condition that should be considered in a setting of recurrent and intractable vomiting in patients with a history of cannabis use.
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大麻素呕吐综合征:漏诊
大麻是世界上种植和滥用最多的非法药物。与大麻的止吐特性相矛盾的是,一种相对较新的大麻素呕吐综合征(CHS)开始被认识到,其特征是周期性呕吐,其间间隔着无症状期。我们报告一例36岁的女性反复出现在急诊室的周期性呕吐,缓解了热水浴。她是一名长期大麻使用者,诊断是在症状出现几年后才确定的。诊断工作并不引人注目,唯一有效的治疗方法是停止吸食大麻。热浴行为是该综合征的一个关键特征。CHS是一种新的临床状况,在有大麻使用史的患者出现复发性和难治性呕吐时应予以考虑。
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