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.
Shin
Young Kook
YK
Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.
Kwon
Joong Goo
JG
Kim
Ka Young
KY
Park
Jae Bum
JB
Han
Seok Jae
SJ
Cheon
Jong Woon
JW
Kim
Eun Young
EY
Kim
Ho Gak
HG
Lee
Tae Sung
TS
Park
Kyung Sik
KS
Won
Kyoung Sook
KS