Improving the diagnosis of cannabinoid hyperemesis syndrome

Burillo-Putze, Guillermo; Darias-Acosta, Ana Teresa; López-Hernández, Ángeles

doi:10.17235/reed.2019.6003/2018

Cited by 2 publications

(1 citation statement)

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“…Treatment is supportive with administration of anti‐emetics, analgesics, and replacement of fluid and electrolyte deficiencies 1 . Individuals can present multiple times to the ED and they may undergo repetitive investigations if the condition is not recognised 3 . Both patients and clinicians may under‐appreciate cannabis as a trigger for the presenting complaint because of the common belief that cannabis is ‘anti‐emetic’ together with well‐established stigma towards individuals who use drugs of abuse biasing the history taken 4 .…”

Section: Introductionmentioning

confidence: 99%

Cannabinoid hyperemesis syndrome: A 6‐year audit of adult presentations to an urban district hospital

Rotella

Ferretti

Raisi

et al. 2022

Emerg Medicine Australasia

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Objective: To describe the local experience of adult patients presenting with cannabinoid hyperemesis syndrome (CHS) to an urban ED in the outer northern suburbs of Melbourne. Methods: Retrospective chart review of adult patients presenting to the ED with a documented history of CHS or equivalent terminology from January 2015 to January 2021. Age, sex, cannabis use, clinical features, pathology results, imaging and symptomatic management were examined as well as outcomes regarding disposition, representation, morbidity and mortality.Results: One hundred and forty-two adult presentations were included. Sixty-seven were unique presentations and 29 were patients who represented during the study period. Most represented within 3 months (37.8%) and most represented at least twice. Males were overrepresented (68.7%). Patients were young (median age 31 years, interquartile range 23-35 years) and all had a history of regular cannabis use (usually daily). Cyclical nausea and/or vomiting was the most common clinical feature compared to others in previously reported diagnostic criteria. Patients typically had elevated white cell counts with associated neutrophilia (75.8%) and mild hypokalaemia (57.9%). Lipase was not elevated, and C-reactive protein was typically less than 50 mmol/L (98.2%). Imaging was not commonly performed but largely normal.Treatment was supportive with antiemetic use, intravenous fluids and analgesia. There were no deaths or admissions to intensive care. Conclusions: Cyclical nausea and vomiting was the most common feature observed in this cohort compared to other clinical features reported in prior studies. Serum lipase was normal and C-reactive protein only mildly elevated. Prospective studies are required to further assess these findings.

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Section: Introductionmentioning

confidence: 99%