Cannabinoid hyperemesis acute renal failure: a common sequela of cannabinoid hyperemesis syndrome

We report the case of a 25-year-old man with an 8-year history of daily marijuana use diagnosed with acute renal failure secondary to cannabinoid hyperemesis syndrome. The patient presented with “constant” vomiting for over a day. His symptoms were completely relieved with compulsive hot showering a...

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Bibliographic Details
Published in:The American journal of emergency medicine 2014-06, Vol.32 (6), p.690.e1-690.e2
Main Authors: Habboushe, Joseph, MD, MBA, Sedor, Jennifer, MD
Format: Article
Language:English
Subjects:
Abdomen
Acute Disease
Acute Kidney Injury - etiology
Adult
Age
Emergency
Emergency medical care
Humans
Hydration
Male
Marijuana Abuse - complications
Nausea
Patients
Syndrome
Temperature
Vomiting - chemically induced
Vomiting - complications
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Summary:We report the case of a 25-year-old man with an 8-year history of daily marijuana use diagnosed with acute renal failure secondary to cannabinoid hyperemesis syndrome. The patient presented with “constant” vomiting for over a day. His symptoms were completely relieved with compulsive hot showering and partially relieved by hot baths, by high ambient room temperature, and transiently after smoking marijuana. The patient was found to have a creatinine of 3.21 and admitted for acute renal failure secondary to cannabinoid hyperemesis syndrome. Cannabinoid hyperemesis syndrome (CHS) is a recently described condition affecting long-term marijuana users. We found 5 other case reports of acute renal failure secondary to CHS [1-5], and a total of 55 case reports of CHS. The unique combination of intractable vomiting and constant hot showers seems to put CHS patients at significant risk of severe dehydration and prerenal failure, a common and distinct entity we suggest be termed cannabinoid hyperemesis acute renal failure (CHARF). The characteristics of cannabinoid hyperemesis acute renal failure patients were similar to CHS patients, except a larger portion were over the age of 30 (4 of 6, vs 30%). Evaluating physicians should maintain a high degree of suspicion for this common sequela of CHS.
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2013.12.013