Cannabinoid hyperemesis syndrome versus hyperemesis gravidarum in adolescent patients: A diagnostic challenge

Introduction: Nausea and vomiting are common in early pregnancy and are often attributed to hyperemesis gravidarum (HG). However, with increasing cannabis use among women of reproductive age, cannabinoid hyperemesis syndrome (CHS) has emerged as an important differential diagnosis. The clinical overlap between these conditions is demonstrated in this case with the aim to bring attention to the diagnostic challenge, especially in the pediatric population. Case Report: A 15-year-old gravida 1 para 0 woman at 6 weeks’ gestation presented with persistent nausea, repeated vomiting, abdominal pain, and dehydration, without any known symptomatic relief. The patient was initially diagnosed with HG, but further history was notable for daily cannabis use for the past one year. Despite supportive management and antiemetic therapy, symptoms persisted until pregnancy termination and cessation of cannabis usage. The patient was later readmitted with similar symptoms after restarting cannabis usage. Conclusion: Cannabinoid hyperemesis syndrome closely mimics HG and may lead to diagnostic confusion during pregnancy. Detailed substance use history, awareness of CHS features, and prompt cannabis cessation are essential for appropriate management.