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Case Reports
. 2019 Dec;98(51):e18365.
doi: 10.1097/MD.0000000000018365.

Highlighting the importance of early diagnosis of cyclic vomiting syndrome in adults: A case report

Cuilan Tang  1 , Ning Dai  2
Affiliations
Case Reports

Highlighting the importance of early diagnosis of cyclic vomiting syndrome in adults: A case report

Cuilan Tang et al. Medicine (Baltimore). 2019 Dec.

Abstract

Introduction: Cyclic vomiting syndrome (CVS) is a potentially exhausting disorder and has an adverse impact on quality of life, but it is poorly recognized and is always misdiagnosed leading to a diagnostic delay of several years, especially in adults.

Patient concerns: We report a case of a 32-year-old woman with recurrent severe nausea, vomiting, and abdominal pain, and repeated visits to the emergency department or the outpatient department for 4 years. Each time she was diagnosed with gastroenteritis or gastritis, and recovered after supportive treatment including antiemetics, maintenance of water and electrolyte balance, and a proton pump inhibitor.

Diagnosis: Laboratory examinations, gastroenteroscopy, chest and abdominal computed tomography, and brain magnetic resonance imaging all failed to reveal abnormalities that would explain her symptoms. Based on typical symptoms and the exclusion of other diseases associated with repeated vomiting, the diagnosis was made as CVS.

Interventions: She was given orally amitriptyline, 50 mg per night, and olanzapine, 1.25 mg per night.

Outcomes: The treatment was effective in inducing remission, and symptoms did not recur after treatment. The treatment lasted for 2 months and stopped. Her symptoms did not recur over the 10-month follow up.

Conclusion: CVS is not rare in adults, but its diagnosis is usually delayed due to poor recognition of the condition. Clinician awareness of CVS should be enhanced to improve early diagnosis.Core tip: Cyclic vomiting syndrome has a tremendous impact on the quality of life, but it is poorly recognized and is always misdiagnosed leading to a diagnostic delay of several years, especially in adults. The article presented a case report of cyclic vomiting syndrome of adult; we hope the article will attribute to increased awareness of physician and reduce delayed diagnosis.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Suggested algorithm for management of cyclic vomiting syndrome.
See this image and copyright information in PMC

References

    1. Pareek N, Fleisher DR, Abell T. Cyclic vomiting syndrome: what a gastroenterologist needs to know. Am J Gastroenterol 2007;102:2832–40. - PubMed
    1. Lombard HC. Evrose de la digestion, caracteriseo par des crises periodiques de vomissements et une profonde modification de l’assimilation. Gazette Medicale de Paris 1861;312.
    1. Gee S. On fitful or recurrent vomiting. St Bart Hosp Rep 1882;18:1–6.
    1. Sagar RC, Sood R, Gracie DJ, et al. Cyclic vomiting syndrome is a prevalent and under-recognized condition in the gastroenterology outpatient clinic. Neurogastroenterol Motil 2018;30:1–7. - PubMed
    1. Keller K, Beule J, Scholz M, et al. [Cyclic vomiting syndrome (CVS) in adults - frequently overlooked?]. Z Gastroenterol 2012;50:694–8. - PubMed

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