Cannabinoid Hyperemesis Syndrome: Reports of Fatal Cases

@article{Nourbakhsh2019CannabinoidHS,
  title={Cannabinoid Hyperemesis Syndrome: Reports of Fatal Cases},
  author={Mahra Nourbakhsh and Angela Miller and Jeffery Gofton and G.R.D. Jones and Bamidele A Adeagbo},
  journal={Journal of Forensic Sciences},
  year={2019},
  volume={64}
}
Cannabinoid hyperemesis syndrome (CHS) is one of the more clinically challenging effects of cannabis consumption. It is characterized by cyclic attacks of nausea and vomiting in chronic cannabinoid users and learned behavior of compulsive hot bathing. The deaths of a 27‐year‐old female, a 27‐year‐old male, and a 31‐year‐old male with a history of CHS are reported. The decedents had a history of cyclical nausea and vomiting, chronic cannabinoid use and negative laboratory, radiological and… 
[Cannabinoid hyperemesis as a differential diagnosis of nausea and vomiting in the emergency department].
TLDR
The case of a young man in whom the diagnosis was made after four presentations due to the typical anamnesis of cannabinoid hyperemesis syndrome is described, where the symptoms completely receded 6 months after presentation by maintaining cannabis abstinence.
Cannabinoid Hyperemesis Syndrome and Panic Disorder in a Pregnant Woman: Diagnostic and Management Considerations
TLDR
The present case is that of a 29-year-old, 15-week pregnant woman who presented with symptoms suggestive of Cannabis induced panic disorder and Cannabis Hyperemesis Syndrome, and was stabilized symptomatically with intravenous fluids, antiemetics and later set up on long-term drug rehabilitation.
Cannabinoid Hyperemesis
Cannabinoid hyperemesis syndrome (CHS) is a paradoxical condition in which a long-term cannabis user suffers an episode of intractable vomiting that may last days separated by longer asymptomatic
Pharmacological management of cannabinoid hyperemesis syndrome: an update of the clinical literature
TLDR
Antipsychotics (such as haloperidol, benzodiazepines, and/or capsaicin cream appear to be the most efficacious in the treatment of this unique disorder.
Treatment of Cannabinoid Hyperemesis With Olanzapine: A Case Series
TLDR
Outcomes of the cases reported here suggest that off-label use of olanzapine may be effective in the symptomatic treatment of refractory CHS and may be the preferred treatment in cases in which comorbid psychotic symptoms or agitation are present.
Cannabinoid hyperemesis syndrome
TLDR
Cannabinoid hyperemesis syndrome was first described in 20041 and associates cyclic nausea and vomiting with abdominal pain in regular cannabis users (defined, in the most comprehensive systematic review on CHS, as at least weekly cannabis use).
Death of a young woman with cyclic vomiting: a case report
TLDR
Death in this woman with cannabinoid hyperemesis syndrome was attributed to a fatal cardiac arrhythmia complicating vomiting-induced hypokalemia and treatment with QT interval prolonging and potentially arrhythmogenic medications, with the identified cardiac genetic mutations listed as contributing factors.
Cannabinoids in Gastrointestinal Disorders
TLDR
This chapter looks at the pathophysiology and current treatment regimens for CHS, as well as the financial and physical impacts of this unfortunate condition due to long-term cannabis use.
Association between Δ9-tetrahydrocannabinol (cannabis, marijuana) and the cannabinoid hyperemesis syndrome
  • S. Lipson
  • Medicine
    Health Education and Care
  • 2020
The use of medical (and recreational) cannabis in moderation, has been purported to ameliorate pain and discomfort from patients suffering from the effects of neoplastic diseases, administration of
Endocannabinoid system and cannabis hyperemesis syndrome: a narrative update.
TLDR
The putative mechanism of cannabis hyperemesis syndrome is described, with an overview of the clinical features in these patients, and a narrative update on the current evidence on CHS pathophysiology, diagnosis, treatment, and identifying research gaps.
...
...

References

SHOWING 1-10 OF 38 REFERENCES
Cannabinoid Hyperemesis Syndrome as the Underlying Cause of Intractable Nausea and Vomiting
TLDR
A case of a 30-year-old man who presented to the emergency department with diffuse abdominal pain, nausea, and intractable vomiting, and reported symptomatic relief with prolonged hot showers, which led to the diagnosis of cannabinoid hyperemesis syndrome.
Cannabinoid hyperemesis: a case series.
Cannabinoid Hyperemesis Syndrome Associated With Compulsive Showering and Acute Kidney Injury.
TLDR
It is found that the description of pain can be varied, as opposed to the traditional description of “colicky pain,” and the bathing behavior specifically helps to distinguish cannabinoid hyperemesis syndrome from cyclic vomiting syndrome.
Cannabinoid hyperemesis syndrome: clinical diagnosis of an underrecognised manifestation of chronic cannabis abuse.
TLDR
In the setting of chronic cannabis abuse, patients presenting with chronic severe nausea and vomiting that can sometimes be accompanied by abdominal pain and compulsive hot bathing behaviour, in the absence of other obvious causes, a diagnosis of cannabinoid hyperemesis syndrome should be considered.
Case of cannabinoid hyperemesis syndrome with long-term follow-up.
TLDR
Physicians should have a high index of suspicion for this under-recognized condition, as excellent long-term prognosis of CHS can be achieved when abstinence is maintained.
Cannabinoid-Induced Hyperemesis: A Conundrum—From Clinical Recognition to Basic Science Mechanisms
TLDR
Human and animal findings suggest that chronic exposure to cannabis may not be a prerequisite for the induction of vomiting but is required for the intensity of emesis.
[Cannabinoid hyperemesis syndrome inducing acute prerenal failure and electrolyte disturbance].
TLDR
Recreational use of cannabis is widespread and may induce a widely unknown syndrome characterized by nausea, vomiting and crampy abdominal pain accompanied by frequent hot showers or bathing that should be recognized as a potential cause of acute prerenal failure.
Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment—a Systematic Review
TLDR
Cannabinoid hyperemesis syndrome is a cyclic vomiting syndrome, preceded by daily to weekly cannabis use, usually accompanied by symptom improvement with hot bathing, and resolution with cessation of cannabis, which appears to be the best treatment.
Cannabinoid Hyperemesis: Marijuana Puts Patients in Hot Water
TLDR
Cannabinoid hyperemesis is a cluster of symptoms characterized by chronic cannabis abuse, cyclical vomiting and compulsive bathing behaviours that can be missed unless an adequate history is taken of illicit drug ingestion.
...
...