Disease characteristics and long-term outcomes of cyclic vomiting syndrome in Singaporean children.

Lynette Goh, Jeremy Meng Dao Ho, Fang Kuan Chiou
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Abstract

Background: Cyclic vomiting syndrome (CVS) and its effect on nutritional status has not been well described.

Aim: To describe the clinical characteristics, treatment and outcomes of children with CVS in Singapore.

Methods: 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.

Results: 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) z 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 z score of these patients from a median of -2.9 to -0.9.

Conclusion: 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.

新加坡儿童周期性呕吐综合征的疾病特点和长期预后
背景:周期性呕吐综合征(CVS)及其对营养状况的影响尚未得到很好的描述。目的:描述新加坡儿童CVS的临床特点、治疗和结局。方法:回顾性队列研究2011 - 2021年在新加坡KK妇女儿童医院诊断的1 - 18岁CVS患儿。结果:研究纳入32名患有CVS的儿童(69%为女性),平均发病年龄为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,没有其他可识别的器质性原因,中位体重指数(BMI) z评分为-3.2(范围为-2至-7.5)。全身性高血压发生率为10%(3/32)。该队列患者的总体平均发作频率为每年4(±4)次。共有16例(50%)患者开始接受预防性治疗,他们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名患者(25%)需要升级到二线治疗。通过预防性治疗,发作频率总体上有所改善,平均每年减少5(±3)次发作。此外,这些患者的BMI z评分中位数从-2.9提高到-0.9。结论:预防治疗可有效改善营养状况,减少症状发生,对于有生长衰竭、明显高血压等并发症的患者应予以考虑。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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