Woman suffers from vomiting 30 times a day likely due to an autoimmune disease

Vomiting episodes come with an “impending sense of doom.”
Nergis Firtina
A woman is vomiting.
A woman is vomiting.


What would you do if you vomited more than ten times in a day? It would be torture, without a doubt. However, a young woman is facing this horrendous situation and throws up 30 times a day, likely because of an autoimmune disease.

Published in Frontiers in Endocrinology on November 10, the report says that a 27-year-old woman also has type 1 diabetes, which affects the immune system as well.

As LiveScience reported, the doctors first examined her in 2016 when the disease's symptoms began. As per the authors, the woman felt an "impending sense of doom and came to our hospital for help in a state of panic" before each episode. Nausea and torturous abdominal pain came with the vomiting. "The episodes were so severe that the patient had vomiting episodes more than 30 times a day, and the vomiting volume could be as large as 6 liters (1.6 gallons)," wrote the authors.

Woman suffers from vomiting 30 times a day likely due to an autoimmune disease
Abdominal pain and cravings came with the vomiting.

The doctors identified the patient as having "cyclic vomiting syndrome" (CVS), a condition marked by abrupt vomiting outbreaks separated by protracted periods without symptoms. The exact reason for this syndrome is not certain yet, but researchers are considering it could result from abnormal hormonal reactions to stress, erroneous nerve signals between the brain and digestive system, or genetic alterations.

It started all over again

Although the patient's symptoms decreased after the consultation, the episodes started again. Then her insulin medication was closely monitored, and her blood sugar dropped and remained low for days.

Dr. Wei Liang, a physician in the endocrinology division at the University of Hong Kong-Shenzhen Hospital and the author of the case report, wrote in an email to Live Science that the medical team examined the patient's entire body to try to unravel this complex case, but "nothing significant was found."

She also added that a blood test for the patient showed "very high" levels of GAD autoantibodies, which are immune molecules that mistakenly attack the body's own tissues and are present in people with type 1 diabetes.

“Vomiting symptoms were remarkably reduced in our patient in the eight-month follow-up after one course of rituximab treatment," Liang told Live Science. The medical team believes that the patient's blood autoantibodies were responsible for her CVS; hence, when those antibodies vanished, the patient's episodes of vomiting stopped as well.

"In our opinion, cyclic vomiting syndrome is not likely linked to diabetes or insulin use," because the syndrome isn't more common in diabetic people than it is in the general public, Liang explained. "Therefore, we think CVS may be a separate autoimmune disorder," she said. 

What is an autoimmune disease?

An autoimmune disease is a sickness that develops when the immune system reacts abnormally to a healthy bodily part. There are at least 80 different forms of autoimmune illnesses, and some data indicate that there may be as many as 100 different types. Nearly every body part can be affected. Low-grade fever and fatigue are typically present along with a variety of other mild to severe common symptoms. There is no known cause. Lupus is one example of an autoimmune disorder that runs in families. Infections or other environmental variables may also play a role in some cases.

The objective and the results of the study:

The aim of this study was to quantify the excess risk of autoimmune hypothyroidism and hyperthyroidism, Addison disease, celiac disease, and atrophic gastritis in adults with type 1 diabetes (T1D) compared with nondiabetic individuals in Finland. This is one of the largest studies quantifying the risk of coexisting AD in adult individuals with T1D in the country with the highest incidence of T1D in the world. The results highlight the importance of continuous screening for other ADs in individuals with T1D.

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