1. Sedation and Acute Encephalopathy in a Pediatric Patient Following Ingestion of Delta-8-Tetrahydrocannabinol Gummies
- Author
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Regan A. Baum, Roy Gerona, Andrew Reckers, Matthew Riley, Ross Ellison, Blake Davidson, Peter Akpunonu, and Jordan Trecki
- Subjects
medicine.medical_treatment ,Sedation ,Encephalopathy ,Intensive Care Units, Pediatric ,Eating ,mental disorders ,medicine ,Cannabidiol ,Humans ,Ingestion ,Dronabinol ,Child ,Tetrahydrocannabinol ,Toxicology testing ,Brain Diseases ,Illicit Drugs ,Cannabinoids ,business.industry ,organic chemicals ,Articles ,General Medicine ,medicine.disease ,Child, Preschool ,Anesthesia ,Toxicity ,Marijuana Use ,Female ,Cannabinoid ,medicine.symptom ,business ,medicine.drug - Abstract
Patient: Female, 2-year-old Final Diagnosis: Acute encephalopathy, resolved • poisoning by delta-8-THC symptoms • altered mental status • respiratory failure Symptoms: Acute encephalopathy • altered mental status • respiratory failure Medication: — Clinical Procedure: — Specialty: Pediatrics and Neonatology • Toxicology Objective: Unusual clinical course Background: Delta-8 tetrahydrocannabinol (delta-8 THC) is an isomer of delta-9-tetrahydrocannabinol (delta-9 THC), the primary psychoactive cannabinoid in the marijuana plant. Typically found at lower concentrations in marijuana, delta-8 THC exhibits psychoactive properties similar to delta-9 THC. Products containing delta-8 THC are readily available across the US and currently there is a lack of available confirmatory testing specific to delta-8 THC as there is cross-reactivity to other naturally occurring cannabinoids in standard immunoassays. Pediatric exposures to this substance are on the rise. Case Report: We present a case with laboratory confirmation of a previously healthy 2-year-old girl ingesting approximately 15 mg/kg of delta-8 THC gummies. The patient arrived minimally responsive and requiring intubation for encephalopathy. Laboratory confirmation of delta-8 THC exposure is not routinely available with common testing modalities. A urine drug screen preformed in the hospital was positive for delta-9 THC. With the collaboration of the Drug Enforcement Administration’s Toxicology Testing Program, detection and confirmation of delta-8 THC was performed in the serum and urine using liquid chromatography-quadrupole time-of-flight mass spectrometry. Conclusions: The prevalence of delta-8 THC-containing products in the illicit drug market is increasing rapidly. Delta-8 THC products are now available in gas stations and in headshops. The clinical presentation of delta-8 THC exposure is similar to known effects of delta-9 THC exposure. These similarities limit the clinicians’ abilities to determine the specific substance ingested. Symptomatic and supportive care remains an effective treatment for cannabinoid toxicity.
- Published
- 2021