Journal of Neurogastroenterology and Motility  2010;16(1):77-82

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

Young Kook SHIN 1 ; Joong Goo KWON ; Ka Young KIM ; Jae Bum PARK ; Seok Jae HAN ; Jong Woon CHEON ; Eun Young KIM ; Ho Gak KIM ; Tae Sung LEE ; Kyung Sik PARK ; Kyoung Sook WON

Affiliations

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Keywords

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

Country

Republic of Korea

Language

English

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.