A case of cyclic vomiting syndrome responding to gonadotropin-releasing hormone analogue.
Cyclic vomiting syndrome (CVS) is a disorder characterized by recurrent episodes of incapacitating nausea and vomiting interspersed with symptom free periods. Common triggers of cyclic vomiting include noxious stress, excitement, fatigue and menstrual period. Here, we report a case of cyclic vomiting syndrome in adult patient characterized by stereotypical vomiting attack, occurring in every menstruation period. Recurrent vomiting episodes began 6 years ago and we treated this patient with subcutaneous injection of goserelin, a gonadotropin-releasing hormone analogue (GnRHa) and oral estrogen. After 4 months of therapy, she was symptom free for the following 5 years, even with the resumed normal menstruation. Recurrence of vomiting attack with same pattern occurred 1 month before readmission. Treatment with intravenous lorazepam aborted vomiting, but could not prevent recurrences of vomiting and epigastric pain. We treated the patient with GnRHa and oral estradiol again which effectively prevented recurrence of the symptoms.
Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.
Young Kook
YK
Shin
Joong Goo
JG
Kwon
Ka Young
KY
Kim
Jae Bum
JB
Park
Seok Jae
SJ
Han
Jong Woon
JW
Cheon
Eun Young
EY
Kim
Ho Gak
HG
Kim
Tae Sung
TS
Lee
Kyung Sik
KS
Park
Kyoung Sook
KS
Won