Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
Department of Pediatric Surgery, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
Nagoya J Med Sci. 2023 May;85(2):357-361. doi: 10.18999/nagjms.85.2.357.
Cyclic vomiting syndrome (CVS) is characterized by recurrent episodes of severe vomiting with a completely asymptomatic interictal interval. Relatively few patients develop CVS in the neonatal period, and an early diagnosis is difficult. We experienced an infant who was diagnosed with neonatal-onset CVS in early infancy. An 8-day-old girl was admitted to our neonatal intensive care unit because of frequent vomiting beginning 12 h after birth and weight loss reaching 84.2% of her birth weight. Despite extensive examinations, no abnormalities to explain the vomiting were found. She continued to vomit, and a cyclical pattern with a vomiting phase lasting for three days followed by a non-vomiting phase lasting for about one to two weeks became obvious. Based on her clinical course, the family history of migraine and the effectiveness of Phenobarbital, she was diagnosed with CVS at three months old. Although CVS is a diagnosis of exclusion, a family history of migraine can aid its early diagnosis. If the illness is suspected in the neonatal period, diagnostic treatment with Phenobarbital may be considered. The case suggests the need to include CVS in the differential diagnosis of neonates with unexplained repetitive vomiting.
周期性呕吐综合征（CVS）的特征是反复发作的严重呕吐，其间歇期完全无症状。相对较少的患者在新生儿期出现 CVS，早期诊断较为困难。我们遇到了一例婴儿，在婴儿早期被诊断为新生儿期起病的 CVS。一名 8 天大的女婴因出生后 12 小时开始频繁呕吐和体重减轻达出生体重的 84.2%而被收入我院新生儿重症监护病房。尽管进行了广泛的检查，但未发现可解释呕吐的异常。她继续呕吐，出现了一种周期性模式，呕吐期持续三天，随后非呕吐期持续约一到两周。根据她的临床病程、偏头痛家族史和苯巴比妥的疗效，她在三个月大时被诊断为 CVS。尽管 CVS 是一种排除性诊断，但偏头痛家族史有助于早期诊断。如果怀疑在新生儿期患病，可以考虑使用苯巴比妥进行诊断性治疗。该病例提示需要将 CVS 纳入不明原因反复呕吐的新生儿鉴别诊断中。
