{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T07:13:25Z","timestamp":1756192405461,"version":"3.37.3"},"reference-count":7,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T00:00:00Z","timestamp":1710806400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T00:00:00Z","timestamp":1710806400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>This report presents a case of cannabinoid-induced hyperemesis syndrome causing repeated violent retching in a patient with a large (8\u00a0cm) adrenal pheochromocytoma resulting in hypertensive urgency.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 69-year-old white male patient with a previously diagnosed pheochromocytoma presented to the emergency department with nausea and vomiting and was found to have hypertensive urgency. Computed tomography scan did not show any acute abdominal pathology and history was inconsistent with a gastrointestinal etiology. Patient had a history of daily cannabinoid use for many years and repeated self-limited hyperemesis episodes, and thus a diagnosis of cannabinoid-induced hyperemesis syndrome was made. It was concluded that the likely explanation for the hypertensive urgency was from physical compression of his adrenal tumor during the episodes of retching resulting in a catecholamine surge. The patient was given antiemetics and admitted to the intensive care unit for blood pressure management. Blood pressure was initially controlled with phentolamine and a\u00a0clevidipine infusion, then transitioned to oral doxazosin and phenoxybenzamine. Hyperemesis and abdominal pain resolved after 24\u00a0hours, and his blood pressure returned to baseline. The patient was discharged with the recommendation to stop all cannabis use. On follow-up, his blood pressure remained well controlled, and he subsequently underwent adrenalectomy for tumor removal.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Hyperemesis can cause hypertensive events in patients with pheochromocytoma by increasing abdominal pressure, leading to catecholamine release.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-024-04497-0","type":"journal-article","created":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T01:02:20Z","timestamp":1710810140000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cannabinoid hyperemesis and pheochromocytoma hypertensive urgency: a case report\u00a0"],"prefix":"10.1186","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-4685-9500","authenticated-orcid":false,"given":"Jeffrey M.","family":"Arendash","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cornel","family":"Chiu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jocelyn","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fred","family":"Mihm","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,3,19]]},"reference":[{"issue":"3","key":"4497_CR1","doi-asserted-by":"publisher","first-page":"191","DOI":"10.2478\/enr-2019-0020","volume":"53","author":"F-A Farrugia","year":"2019","unstructured":"Farrugia F-A, Charalampopoulos A. Pheochromocytoma. Endocr Regul. 2019;53(3):191\u2013212.","journal-title":"Endocr Regul"},{"issue":"8","key":"4497_CR2","doi-asserted-by":"publisher","first-page":"956","DOI":"10.1001\/archsurg.1988.01400320042007","volume":"123","author":"KA Newell","year":"1988","unstructured":"Newell KA. Pheochromocytoma multisystem crisis. Arch Surg. 1988;123(8):956.","journal-title":"Arch Surg"},{"issue":"6","key":"4497_CR3","first-page":"571","volume":"33","author":"A Perisetti","year":"2020","unstructured":"Perisetti A. Cannabis hyperemesis syndrome: an update on the pathophysiology and management. Ann Gastroenterol. 2020;33(6):571\u20138.","journal-title":"Ann Gastroenterol"},{"issue":"3","key":"4497_CR4","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1016\/j.jemermed.2017.12.010","volume":"54","author":"JR Richards","year":"2018","unstructured":"Richards JR. Cannabinoid hyperemesis syndrome: pathophysiology and treatment in the emergency department. J Emerg Med. 2018;54(3):354\u201363.","journal-title":"J Emerg Med"},{"issue":"1","key":"4497_CR5","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1007\/s13181-016-0595-z","volume":"13","author":"CJ Sorensen","year":"2016","unstructured":"Sorensen CJ, DeSanto K, Borgelt L, Phillips KT, Monte AA. Cannabinoid hyperemesis syndrome: diagnosis, pathophysiology, and treatment\u2014A systematic review. J Med Toxicol. 2016;13(1):71\u201387.","journal-title":"J Med Toxicol"},{"issue":"7999","key":"4497_CR6","doi-asserted-by":"publisher","first-page":"1357","DOI":"10.1016\/S0140-6736(76)92008-0","volume":"308","author":"PF Plouin","year":"1976","unstructured":"Plouin PF, Menard J, Corvol P. Hypertensive crisis in patient with phaeochromocytoma given metoclopramide. Lancet. 1976;308(7999):1357\u20138.","journal-title":"Lancet"},{"key":"4497_CR7","doi-asserted-by":"publisher","first-page":"2571","DOI":"10.1007\/s00464-008-0080-0","volume":"22","author":"A Iqbal","year":"2008","unstructured":"Iqbal A, Haider M, Stadlhuber RJ, Karu A, Corkill S, Filipi CJ. A study of intragastric and intravesicular pressure changes during rest, coughing, weight lifting, retching, and vomiting. Surg Endosc. 2008;22:2571\u20135.","journal-title":"Surg Endosc"}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-024-04497-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13256-024-04497-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-024-04497-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T01:02:42Z","timestamp":1710810162000},"score":1,"resource":{"primary":{"URL":"https:\/\/jmedicalcasereports.biomedcentral.com\/articles\/10.1186\/s13256-024-04497-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,19]]},"references-count":7,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["4497"],"URL":"https:\/\/doi.org\/10.1186\/s13256-024-04497-0","relation":{},"ISSN":["1752-1947"],"issn-type":[{"type":"electronic","value":"1752-1947"}],"subject":[],"published":{"date-parts":[[2024,3,19]]},"assertion":[{"value":"16 October 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 March 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 March 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"161"}}