How Doctors Can Tell Cannabinoid Hyperemesis From Cyclic Vomiting in Teens
In a pediatric hospital study, cannabinoid hyperemesis syndrome patients were older, had higher blood pressure, lower potassium, and higher creatinine than cyclic vomiting syndrome patients, while abdominal imaging was rarely useful for either condition.
Quick Facts
What This Study Found
Patients with CHS were significantly older (mean 18.1 vs 14.5 years), more likely to have a positive urine drug screen (86% vs 2.9%), had lower potassium, higher creatinine, and higher systolic blood pressure compared to CVS patients. Imaging was obtained in 36% of all patients but only 2.4% showed abnormalities.
Key Numbers
125 patients included (out of 201 screened). CHS mean age: 18.06 years vs CVS: 14.50 years. Positive urine drug screen: CHS 86% vs CVS 2.9%. CHS systolic BP: 124.46 vs CVS: 118.55 mmHg. Imaging abnormalities in only 2.4% of cases.
How They Did This
Retrospective chart review of 125 patients admitted to a large children's health care system from 2015 through 2022. Patients were identified using ICD-9 and ICD-10 codes for CHS and CVS.
Why This Research Matters
CHS and CVS present almost identically with recurrent nausea, vomiting, and abdominal pain. Misdiagnosis delays appropriate treatment. These distinguishing clinical features could help pediatric providers reach the correct diagnosis faster and avoid unnecessary imaging.
The Bigger Picture
As cannabis use among adolescents continues, CHS is becoming more common in pediatric settings. Having objective clinical markers to distinguish it from CVS could reduce diagnostic delays, unnecessary testing, and inappropriate treatment.
What This Study Doesn't Tell Us
Retrospective design with ICD code-based identification may miss or misclassify cases. Single health care system. The sample of CHS patients may include only those with confirmed cannabis use, potentially missing cases where use was denied or undetected.
Questions This Raises
- ?Can these distinguishing features be validated prospectively into a clinical decision tool?
- ?Why is blood pressure higher in CHS?
- ?Is the elevated creatinine in CHS related to dehydration from vomiting or a direct cannabis effect?
Trust & Context
- Key Stat:
- Abdominal imaging was abnormal in only 2.4% of cases
- Evidence Grade:
- Retrospective cohort from a single institution with reasonable sample size but inherent limitations of chart review.
- Study Age:
- 2024 study using 2015-2022 data
- Original Title:
- Distinguishing Clinical Features of Cannabinoid Hyperemesis Syndrome and Cyclic Vomiting Syndrome: A Retrospective Cohort Study.
- Published In:
- The Journal of pediatrics, 271, 114054 (2024)
- Database ID:
- RTHC-05700
Evidence Hierarchy
Looks back at existing records to find patterns.
What do these levels mean? →Frequently Asked Questions
How can doctors tell CHS apart from cyclic vomiting syndrome?
This study found CHS patients tend to be older (18 vs 14.5 years), have positive drug screens (86% vs 3%), higher blood pressure, lower potassium, and higher creatinine than CVS patients.
Is imaging useful for diagnosing CHS or CVS?
Rarely. Only 2.4% of imaging studies showed abnormalities, suggesting that imaging has low yield for distinguishing or diagnosing these conditions.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-05700APA
Shah, Meera; Jergel, Andrew; George, Roshan P; Jenkins, Elan; Bashaw, Hillary. (2024). Distinguishing Clinical Features of Cannabinoid Hyperemesis Syndrome and Cyclic Vomiting Syndrome: A Retrospective Cohort Study.. The Journal of pediatrics, 271, 114054. https://doi.org/10.1016/j.jpeds.2024.114054
MLA
Shah, Meera, et al. "Distinguishing Clinical Features of Cannabinoid Hyperemesis Syndrome and Cyclic Vomiting Syndrome: A Retrospective Cohort Study.." The Journal of pediatrics, 2024. https://doi.org/10.1016/j.jpeds.2024.114054
RethinkTHC
RethinkTHC Research Database. "Distinguishing Clinical Features of Cannabinoid Hyperemesis ..." RTHC-05700. Retrieved from https://rethinkthc.com/research/shah-2024-distinguishing-clinical-features-of
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.