Severe Hypophosphatemia in Adolescent Cannabis User

Cannabinoid hyperemesis syndrome (CHS) involves cyclical nausea, vomiting, and abdominal pain linked to use of cannabis with resolution of symptoms upon cessation of cannabinoids. Although electrolyte disturbances, fluid imbalances, and nutritional deficiencies are known complications of CHS in the setting of intractable vomiting, severe hypophosphatemia is a rare clinical phenomenon cited primarily in the adult literature. Pediatric cases are scarcer, thus the magnitude associated with our patient case describes an adolescent diagnosed with CHS complicated by recurrent severe hypophosphatemia. As cannabis accessibility and potential for abuse increase with the wave of legalization seen at the state level, clinician awareness is needed for such adverse entities related to cannabinoid toxicity.