Pediatric Cannabinoid Hyperemesis: A Single Institution 10-Year Case Series

Paediatric cannabinoid hyperemesis

“…Prevalence in adolescents is more difficult to estimate, the largest study of paediatric CHS to date reported on 34 patients in a single institution [11 ▪ ]. Adolescent CHS is more common in girls and has been reported in patients as young as 13 years old [11 ▪ ]. Diagnosis may be hampered by nonspecific clinical findings, a lack of confirmatory test and the challenges of obtaining a detailed substance use history in adolescents.…”

Adolescent Cannabis Hyperemesis Syndrome During the COVID-19 Pandemic

“…A previously reported 10-year case series from our institution—a 257-bed tertiary pediatric academic facility with an on-site outpatient surgical day center—identified 34 patients with CHS, an average of 3 to 4 patients per year. 1 Patients were included in the series if they had a cannabinoid hyperemesis–related International Classification of Diseases, Ninth or Tenth Revision , code and an accompanying diagnosis of nausea and vomiting or abdominal pain. During the 4-month period April 1, 2020, to July 31, 2020, 6 patients who fit these criteria presented.…”

“…Presenting symptoms are nausea, vomiting, and abdominal pain, and a hallmark symptom is compulsive bathing behavior with hot showers. Our group has previously published pragmatic criteria for diagnosis of CHS in adolescents, 1 but the diagnosis is essentially one of exclusion in the presence of a patient-endorsed history of long-term cannabis use and cyclical nausea and vomiting with or without supporting features. The only known long-term effective treatment is continuing abstinence from cannabis use.…”

The Coming Storm: Cannabis Hyperemesis Syndrome in Adolescents

“…In this issue of the Journal of Adolescent Health, Lonsdale et al [7] report on 10 years of patient experience at a single institution, the Johns Hopkins All Children's Hospital in St Petersburg, FL, (U.S.). In this retrospective analysis of all admissions to their institution over a 10-year period (2007e2016), the researchers identified 34 individual subjects aged between 13 and 20 years who were admitted for paroxysmal episodes of emesis in the presence of chronic cannabis use.…”

“…Patients seen for CHS in the emergency room frequently receive high doses of ondansetron, a medication that can lead to QTc prolongation. Although the use of ondansetron in children with acute gastroenteritis is considered safe [13], patients with CHS as mentioned in the review by Lonsdale and Brown [7] receive large amounts of the drug. No research on arrhythmias in adolescents with CHS was yet published.…”