What is the role of lab tests in the workup of cyclic vomiting syndrome?

Updated: Oct 31, 2018
  • Author: Thangam Venkatesan, MD; Chief Editor: Carmen Cuffari, MD  more...
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Answer

In the evaluation of the patient for possible GI disease, screening blood work should include a complete blood count (CBC) with differential, assessment of the erythrocyte sedimentation rate (ESR), and measurement of levels of hepatic transaminases, pancreatic amylase, and lipase. Nonanatomic renal disease can be detected by means of serum blood urea nitrogen (BUN) and creatinine tests, urinalysis, and urine calcium-to-creatinine ratio. [48]

Screening for multiple metabolic and endocrine disorders can be accomplished by assessing pH and measuring levels of electrolytes, glucose, lactic acid, ammonia, amino acids, adrenocorticotropic hormone (ACTH), and antidiuretic hormone (ADH).

Urinary ketones, organic acids, ester-to-free carnitine ratio, porphobilinogen, and aminolevulinic acid may also guide diagnosis in the correct direction. [48] These metabolic and endocrine tests must be obtained during the vomiting episode to detect intermittent disorders (eg, disorder of fatty acid oxidation) or heterozygote disorders (eg, partial ornithine transcarbamylase deficiency).

All blood and urine tests must be performed before the administration of intravenous (IV) fluids containing glucose or other medical treatments.

In a postmenarchal girl, the physician must consider a beta human chorionic gonadotropin (beta-hCG) test for pregnancy. [48]


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