Catamenial cyclic vomiting syndrome responding to Oestrogen therapy: an adolescent case report

Abstract

Cyclic vomiting syndrome (CVS) is defined by episodes of vomiting lasting from a few hours to several days, alternating with periods of no symptoms. Various symptoms can be associated with vomiting such as nausea, migraine or abdominal pain. Common triggers of CVS include infection, psychological stress and menstruation. CVS's diagnosis requires exclusion of alternative diseases particularly neurological and gastrointestinal. CVS shares many common features with catamenial migraine including treatment. We herein report a case of CVS in a 16 years old girl characterized by stereotypical vomiting attacks occurring in every menstrual period. Recurrent vomiting episodes began 2 years before admission. Given the negativity of paraclinical exams and the absence of response to different therapeutic approaches as well as the similarity with catamenial migraine, we treated our patient with permenstrual percutaneous oestrogen for six months. The evolution was marked by the disappearance of symptoms within the first month and the absence of their recurrence after treatment cessation during a follow-up of 6 years.

Síndrome de vomito cíclico en niños: ¿cuál es la evidencia?

“…De manera similar a la migraña catamenial, algunas adolescentes desarrollan SVC al comienzo del periodo menstrual. Se piensa que este fenómeno es el resultado de la intolerancia a la disminución de estrógenos al final del ciclo menstrual, y muchas pacientes con este subtipo de SVC responden adecuadamente al tratamiento con dosis bajas de estrógeno, anticonceptivos orales con progesterona o inyecciones intramusculares de medroxiprogesterona cada tres meses 44 .…”

Cyclic Vomiting Syndrome in Children

“…Low estrogen oral contraceptives can be used to treat girls with menstrual-related CVS (165). Anecdotal experience suggests that acupuncture may attenuate the severity of CVS attacks (166).…”