Goh Lynette, Ho Jeremy Meng Dao, Chiou Fang Kuan
Department of Gastroenterology, Hepatology and Nutrition, KK Women's and Children's Hospital, Singapore 229899, Singapore.
Department of Paediatrics, KK Women's and Children's Hospital, Singapore 229899, Singapore.
World J Gastrointest Pharmacol Ther. 2025 Jun 5;16(2):103971. doi: 10.4292/wjgpt.v16.i2.103971.
Cyclic vomiting syndrome (CVS) and its effect on nutritional status has not been well described.
To describe the clinical characteristics, treatment and outcomes of children with CVS in Singapore.
Retrospective cohort study of pediatric patients aged 1 to 18 years old with CVS diagnosed at KK Women's and Children's Hospital in Singapore from 2011 to 2021.
Thirty-two children (69% female) with CVS were included in the study, with mean age of onset of symptoms at 7 (± 4) years and mean follow up duration of 5 years. Forty percent (12/32) of patients were underweight at diagnosis with no other identifiable organic cause, with a median body mass index (BMI) score -3.2 (range -2 to -7.5). The incidence of systemic hypertension was 10% (3/32). The overall mean frequency of exacerbations in this cohort of patients was 4 (± 4) episodes per year. In total, 16 (50%) patients, who had mean baseline frequency of 6 (± 5) attacks per year, were commenced on prophylactic treatment. Twelve patients (75%) responded to first-line therapy, whereas 4 (25%) required escalation to second-line treatment. With prophylactic treatment, there was an overall improvement in the frequency of attacks with a mean reduction of 5 (± 3) attacks per year. Also, there was improvement in the BMI score of these patients from a median of -2.9 to -0.9.
Prophylactic treatment is effective in improving nutritional status as well as reducing symptom frequency and should be considered for patients with complications such as growth failure and significant hypertension.
周期性呕吐综合征（CVS）及其对营养状况的影响尚未得到充分描述。
描述新加坡患有CVS的儿童的临床特征、治疗方法及治疗结果。
对2011年至2021年在新加坡KK妇女儿童医院诊断为CVS的1至18岁儿科患者进行回顾性队列研究。
本研究纳入了32名患有CVS的儿童（69%为女性），症状出现的平均年龄为7（±4）岁，平均随访时间为5年。40%（12/32）的患者在诊断时体重过轻，且无其他可识别的器质性病因，体重指数（BMI）中位数为-3.2（范围为-2至-7.5）。系统性高血压的发生率为10%（3/32）。该队列患者发作的总体平均频率为每年4（±4）次。共有16名（50%）患者开始接受预防性治疗，这些患者发作的平均基线频率为每年6（±5）次。12名患者（75%）对一线治疗有反应，而4名（25%）患者需要升级至二线治疗。通过预防性治疗，发作频率总体有所改善，平均每年减少5（±3）次发作。此外，这些患者的BMI评分从中位数-2.9改善至-0.9。
预防性治疗在改善营养状况以及减少症状发作频率方面有效，对于伴有生长发育迟缓及严重高血压等并发症的患者应考虑采用。
