Cyclic vomiting associated with excessive dopamine in Riley-day syndrome.
OBJECTIVE
To analyze the neurochemical profile during the recurrent attacks of nausea and vomiting in patients with Riley-day syndrome.


BACKGROUND
One of the most disabling features of patients with Riley-day syndrome are recurrent attacks of severe nausea/retching/vomiting accompanied by hypertension, tachycardia, and skin flushing, usually triggered by emotional or other stresses.


METHODS
We monitored blood pressure and heart rate and measured plasma catecholamines during typical dysautonomic crises triggered by emotionally charged situations. For comparison, measurements were repeated at follow-up after the symptoms had resolved and the patients were feeling calm and well.


RESULTS
During a typical attack, patients were hypertensive and tachycardic. In all patients, circulating levels of norepinephrine (P < 0.002) and dopamine (P < 0.007) increased significantly.


CONCLUSIONS
Activation of dopamine receptors in the chemoreceptor trigger zone may explain the cyclic nausea/retching/vomiting of patients with Riley-day syndrome.
Department of Physiology and Neuroscience, New York University School of Medicine, New York, NY, USA. Horacio.Kaufmann@nyumc.org
Lucy J
LJ
Norcliffe-Kaufmann
Felicia B
FB
Axelrod
Horacio
H
Kaufmann
D000293:Adolescent; D000328:Adult; D001794:Blood Pressure; D002675:Child, Preschool; D004298:Dopamine / Q000097:blood*; D004402:Dysautonomia, Familial / Q000097:blood / Q000150:complications* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D004644:Emotions; D005260:Female; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000209:etiology / Q000503:physiopathology; D008297:Male; D009638:Norepinephrine / Q000097:blood; D012008:Recurrence; D013564:Sympathetic Nervous System / Q000378:metabolism* / Q000503:physiopathology; D013610:Tachycardia / Q000097:blood / Q000209:etiology / Q000503:physiopathology; D013997:Time Factors; D015854:Up-Regulation; D014839:Vomiting / Q000097:blood / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D055815:Young Adult
D004298:Dopamine; D009638:Norepinephrine