Akutes prärenalesNierenversagen und Elektrolytentgleisung durch das Cannabis-induzierteHyperemesis-Syndrom

HISTORY AND CLINICAL FINDINGS: A 36-year-old patient presented to the psychiatric clinic with presumed worsening of a chronic psychosis. INVESTIGATIONS: Laboratory values revealed acute renal failure and electrolyte imbalance. A further diagnostic work-up including urine analysis as well as abdominal und retroperitoneal sonography was normal. DIAGNOSIS, THERAPY AND CLINICAL COURSE: By exact history taking the clinical diagnosis of a cannabinoid hyperemesis syndrome (CHS) was established. Symptomatic treatment with intravenous fluids and electrolytes together with strict cannabis abstinence completely resolved all symptoms and normalized all pathologic values. CONCLUSION: Recreational use of cannabis is widespread. It may induce a widely unknown syndrome characterized by nausea, vomiting and crampy abdominal pain accompanied by frequent hot showers or bathing. This syndrome should be recognized as a potential cause of acute prerenal failure.