Abstract
Introduction: Cyclic vomiting syndrome (CVS) is characterized by recurrent episodes of intense nausea and vomiting interpreted with symptom free period. As data regarding the pattern of disease in our region is scarce, we performed this study to investigate the pattern of pediatric cyclic vomiting in Shiraz, southern Iran. Methods and Patients: This study was performed in Nemazee Hospital, territory health care center affiliated with Shiraz University of Medical Sciences from 2000 to 2010. Medical files were reviewed and data was collected by means of a checklist. Patients were divided into two groups including 1-13 years of age as children and those 13-18 years of age as adolescents. Results: Overall, 43 patients with CVS were included, among whom there were 26 (60.5%) females. The mean age at first attack was found to be 6.2 (3.7) years. Ten patients (23.3%) had a family history of migraine among which there were 8 females. The most common clinical complaint was found to be abdominal pain in 32 (74.4%) patients. GI (gastrointestinal) disorders were more common in the adolescent group rather than the children group (p=0.007).The most common trigger factor was upper respiratory tract infection (URI) detected in 13 patients (30.2%).The most associated disorder was abdominal migraine in 5 (11.6%) patients. Anemia was more common in the adolescent group (p=0.009) than in the children’s group .There were no radiological and laboratory abnormalities among these patients. The most commonly used medications were anti-migraines in 31 (72.0%) patients.Conclusion: as there is no definite drug for CVS, knowing the common trigger factors which culminate in CVS in each region can be of great importance and can prevent attacks in the prodromal phase. [GMJ. 2012;1(1):29-34]
Highlights
Cyclic vomiting syndrome (CVS) is a rare syndrome characterized by recurrent episodes of intense nausea and vomiting interrupted by symptom-free periods [1]
CVS was diagnosed according to the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition consensus criteria: 1 all patients had at least 5 attacks in any interval, or a minimum of 3 attacks during a 6 month period; 2 episodic attacks of intense nausea and vomiting lasted 1 hour to10 days, occurring at least 1 week apart; 3 every patient had his or her stereotypical pattern and symptoms; 4 vomiting during attacks occurred at least 4 times for at least 1 hour; 5 all patients returned to the baseline health between the episodes; and 6 their symptoms were not attributed to another disorder
This study reveals the pattern of the disease in pediatric patients with CVS in the southern part of Iran
Summary
Cyclic vomiting syndrome (CVS) is a rare syndrome characterized by recurrent episodes of intense nausea and vomiting interrupted by symptom-free periods [1]. The disease was first described in 1882 by Gee S, [2] and it is estimated that 1.9-2.3% of the pediatric population is affected. Haghighat M. et al [11] described the pattern and the clinical entity of CVS in Iranian patients; they did not evaluate the trigger factors nor the detailed demographic, clinical, and laboratory entities of the disease. This study was performed in order to evaluate these parameters in Iranian pediatric patients with CVS
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