Cannabinoidinduzierte Hyperemesis

Zusammenfassung

Wir berichten über einen 29-jährigen Patienten mit jahrelangem Cannabismissbrauch, der sich mit rezidivierender Übelkeit, Erbrechen und abdominellen Schmerzen vorstellte. Abstinenz von Cannabis führte zum Sistieren der Beschwerden. Bei chronischer, schwerer Übelkeit und Erbrechen, vor allem in Kombination mit abdominellen Schmerzen und zwanghaftem heißen Baden ist bei Ausschluss anderer Ursachen an eine cannabinoidinduzierte Hyperemesis zu denken. Pathophysiologische und therapeutische Implikationen des Falles werden diskutiert.

Abstract

In this case report, we describe a 29 year-old male patient with a history of chronic cannabis abuse presenting with recurrent vomiting, intense nausea and abdominal pain. Abstinence from cannabis resolved both vomiting and abdominal pain. We conclude that in case of chronic cannabis abuse, patients presenting with severe and chronic nausea, vomiting, accompanied by abdominal pain and compulsive behaviour (hot bathing), in the absence of other obvious causes, the diagnosis of cannabinoid-induced hyperemesis syndrome should be considered.

Schlüsselwörter

Cannabis - Cannabinoid-Hyperemesis - Übelkeit - Erbrechen

Keywords

cannabis - cannabinoid-induced hyperemesis - vomiting

Literatur

• 1 Baker D, Pryce G, Giovannoni G et al. The therapeutic potential of cannabis.  Lancet Neurol. 2003;  2 291-298
• 2 National Institutes of Health website .NIDA Info Facts: Marijuana.. National Institute on Drug Abuse; http://www.nida.nih.gov/Infofacts/marijuana.html
• 3 Deutsche Hauptstelle für Suchtfragen e. V. .Jahrbuch Sucht 2010.. Geesthacht: Neulandverlag; 2010
• 4 Childers S R, Breivogel C S. Cannabis and endogenous cannabinoid systems.  Drug Alcohol Depend. 1998;  51 173-187
• 5 Foley J D. Adolescent use and misuse of marijuana.  Adolesc Med Clin. 2006;  17 319-334
• 6 Tramèr M R, Carroll D, Campbell F A et al. Cannabinoids for control of chemotherapy induced nausea and vomiting: quantitative systematic review.  BMJ. 2001;  323 16-21
• 7 Walsh D, Nelson K A, Mahmoud F A. Established and potential therapeutic applications of cannabinoids in oncology.  Support Care Cancer. 2003;  11 137-143
• 8 Davis M, Maida V, Daeninck P et al. The emerging role of cannabinoid neuromodulators in symptom management.  Support Care Cancer. 2007;  15 63-71
• 9 Sontineni S P, Chaudhary S, Sontineni V et al. Cannabinoid hyperemesis syndrome: Clinical diagnosis of an underrecognised manifestation of chronic cannabis abuse.  World J Gastroenterol. 2009;  15 1264-1266
• 10 Vaziri N D, Thomas R, Sterling M et al. Toxicity with intravenous injection of crude marijuana extract.  Clin Toxicol. 1981;  18 353-366
• 11 Allen J H, de Moore G M, Heddle R et al. Cannabinoid hyperemesis: cyclical hyperemesis in association with chronic cannabis abuse.  Gut. 2004;  53 1566-1570
• 12 Boeckxstaens G E. Cannabinoid hyperemesis with the unusual symptom of compulsive bathing.  Ned Tijdschr Geneeskd. 2005;  149 1468-1471
• 13 Chepyala P, Olden K W. Cyclic vomiting and compulsive bathing with chronic cannabis abuse.  Clin Gastroenterol Hepatol. 2008;  6 710-712
• 14 Roche E, Foster P N. Cannabinoid hyperemesis: not just a problem in Adelaide Hills.  Gut. 2005;  54 731
• 15 Chang Y H, Windish D M. Cannabinoid hyperemesis relieved by compulsive bathing.  Mayo Clin Proc. 2009;  84 76-78
• 16 de Moore G M, Baker J, Bui T. Psychogenic vomiting complicated by marijuana abuse and spontaneous pneumomediastinum.  Aust N Z J Psychiatry. 1996;  30 290-294
• 17 Simoneau I I, Hamza M S, Mata H P et al. The cannabinoid agonist WIN55,212-2 suppresses opioid-induced emesis in ferrets.  Anesthesiology. 2001;  94 882-887
• 18 McCallum R W, Soykan I, Sridhar K R et al. Delta-9-tetrahydrocannabinol delays the gastric emptying of solid food in humans: a double-blind, randomized study.  Aliment Pharmacol Ther. 1999;  13 77-80
• 19 Pertwee R G. Cannabinoids and the gastrointestinal tract.  Gut. 2001;  48 859-867
• 20 Abell T L, Adams K A, Boles R G et al. Cyclic vomiting syndrome in adults.  Neurogastroenterol Motil. 2008;  20 269-284
• 21 Busse F, Omidi L, Leichtle A et al. Lead Poisoning Due to Adulterated Marijuana.  N Engl J Med. 2008;  358 1641-1642
• 22 Busse F P, Fiedler G M, Leichtle A et al. Bleiintoxikation durch gestrecktes Marihuana in Leipzig.  Dtsch Arztebl. 2008;  105 757-762