Cannabinoid Hyperemesis Syndrome Presenting With Recurrent Acute Renal Failure

Abstract

Cannabinoid hyperemesis syndrome is a recently recognized clinical syndrome characterized by chronic cannabis use, profound vomiting and compulsive bathing among other features. Despite the degree of vomiting associated with this disorder, renal impairment and electrolyte disturbances are not commonly reported findings. We report the case of a 36-year-old male with a history of chronic daily cannabis use, who presented to our hospital with acute renal impairment five times in 4 years, with nearly identical clinical picture in each presentation. His symptom complex in each admission consisted of severe nausea and vomiting, compulsive hot showers, and resolution of symptoms within days of abstaining from cannabis. His clinical course included significantly abnormal basic metabolic panels at the time of each admission, with return to normal baseline values 96 hours following hydration in every case. The other consistent findings on admission were hypochloremic, hyponatremic dehydration with mixed metabolic alkalosis and high anion gap metabolic acidosis. He also had proteinuria and microscopic hematuria.This case highlights a serious and potentially life-threatening complication of the disorder. The consistency of the findings suggests a pattern that is associated with this disorder. It is unclear whether the course of renal involvement is benign in the long term.




J Med Cases. 2013;4(3):173-175
doi: https://doi.org/10.4021/jmc939w