J Neurogastroenterol Motil.  2010 Jan;16(1):77-82.

A Case of Cyclic Vomiting Syndrome Responding to Gonadotropin-Releasing Hormone Analogue

Affiliations
  • 1Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea. kwonjg@cu.ac.kr
  • 2Department of Obstetrics and Gynecology, Catholic University of Daegu School of Medicine, Daegu, Korea.
  • 3Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.
  • 4Department of Nuclear Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.

Abstract

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 vom - iting 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.

Keyword

Cyclic vomiting syndrome; Menstrual period; Gonodotropin-releasing hormone analogue

MeSH Terms

Adult
Estradiol
Estrogens
Fatigue
Female
Gonadotropin-Releasing Hormone
Goserelin
Humans
Injections, Subcutaneous
Lorazepam
Menstruation
Nausea
Recurrence
Vomiting
Estradiol
Estrogens
Gonadotropin-Releasing Hormone
Goserelin
Lorazepam
Vomiting
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