Sedation and acute encephalopathy in a pediatric patient following ingestion of delta-8-tetrahydrocannabinol gummies

Peter Akpunonu, Regan A. Baum, Andrew Reckers, Blake Davidson, Ross Ellison, Matthew Riley, Jordan Trecki, Roy Gerona

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Objective: Background: Case Report: Conclusions: Unusual clinical course 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 readi-ly 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 ex-posures to this substance are on the rise. 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 en-cephalopathy. 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 collabo-ration 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. 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.

Original languageEnglish
Article numbere933488
JournalAmerican Journal of Case Reports
Volume22
Issue number1
DOIs
StatePublished - 2021

Bibliographical note

Funding Information:
Peter Akpunonu, e-mail: Peter.akpunonu@uky.edu This research was supported by Grant or Cooperative Agreement number 1 NU17CE924971-01-00, funded by the Centers for Disease Control and Prevention, and contract number 15DDHQ19F0000086, funded by the Drug Enforcement Administration. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention, the Department of Health and Human Services, or the Drug Enforcement Administration None declared

Funding Information:
This research was supported by Grant or Cooperative Agreement number 1 NU17CE924971-01-00, funded by the Centers for Disease Control and Prevention, and contract number 15DDHQ19F0000086, funded by the Drug Enforcement Administration. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention, the Department of Health and Human Services, or the Drug Enforcement Administration.

Publisher Copyright:
© Am J Case Rep, 2021.

Keywords

  • Cannabidiol
  • Illicit Drugs
  • Intensive Care Units, Pediatric
  • Marijuana Use

ASJC Scopus subject areas

  • Medicine (all)

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