title: Metabolic etiologies of cyclic or recurrent vomiting.
abstract: Treatable metabolic diseases are infrequently considered in the differential diagnosis of a child with cyclic or recurrent vomiting. Helpful clues in a complete medical history can heighten a clinician's suspicion about a metabolic etiology, as can the presence of certain symptom complexes or biochemical features. A rational approach to investigation is discussed using routine laboratory tests as a first-line screen. More definitive testing is indicated when screening results are abnormal or when the patient's history is particularly suggestive. Until test results become available, patients in whom a metabolic etiology cannot be ruled out should be treated as if they have an inborn error, in parallel with other conventional therapies, to avoid complications that are often preventable.
authors.affiliation: Metabolism Service, Children's Hospital, Boston, MA 02115, USA.
authors.forename: M
authors.initials: M
authors.lastname: Korson
mesh_terms: D002648:Child; D006801:Humans; D008487:Medical History Taking; D008659:Metabolic Diseases / Q000150:complications* / Q000628:therapy; D010507:Periodicity; D012008:Recurrence; D014839:Vomiting / Q000209:etiology*