Key result
Dysautonomic vomiting crises in Riley-Day syndrome are linked to significantly higher norepinephrine and dopamine levels.
Observational
GOALS: To analyze the neurochemical profile during the recurrent attacks of nausea and vomiting in patients with Riley-day syndrome. BACKGROUND: One of the most disabling features of patients with Riley-day syndrome are recurrent attacks of severe nausea/retching/vomiting accompanied by hypertension, tachycardia, and skin flushing, usually triggered by emotional or other stresses. STUDY: We monitored blood pressure and heart rate and measured plasma catecholamines during typical dysautonomic crises triggered by emotionally charged situations. For comparison, measurements were repeated at follow-up after the symptoms had resolved and the patients were feeling calm and well. RESULTS: During a typical attack, patients were hypertensive and tachycardic. In all patients, circulating levels of norepinephrine (P < 0.002) and dopamine (P < 0.007) increased significantly. CONCLUSIONS: Activation of dopamine receptors in the chemoreceptor trigger zone may explain the cyclic nausea/retching/vomiting of patients with Riley-day syndrome.
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Norcliffe‐Kaufmann et al. (2012) conducted an observational in Riley-Day syndrome with recurrent attacks of nausea and vomiting. Dysautonomic crisis triggered by emotionally charged situations vs. Calm, symptom-free state at follow-up was evaluated on Circulating plasma levels of norepinephrine and dopamine, blood pressure, and heart rate (p=< 0.002 for norepinephrine; < 0.007 for dopamine). Dysautonomic vomiting crises in Riley-Day syndrome were associated with significantly increased circulating norepinephrine (P<0.002) and dopamine (P<0.007) compared with calm follow-up.
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