Not safe for consumption: Synthetic cannabinoids causing fatal acute rhabdomyolysis in two young men

Paul, Anthea B. Mahesan; Simms, Lary; Paul, Abraham Ebenezer; Schmidseder, Christopher; Mahesan, Andrew A.; Yorke, Jojo

doi:10.5348/ijcri-201612-cs-10073

IJCRI

2016

DOI: 10.5348/ijcri-201612-cs-10073

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Not safe for consumption: Synthetic cannabinoids causing fatal acute rhabdomyolysis in two young men

Anthea B. Mahesan Paul¹,

Lary Simms²,

Abraham Ebenezer Paul³

et al.

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Cited by 4 publications

References 8 publications

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McArdle disease: a “pediatric” disorder presenting in an adult with acute kidney injury

Zhao

Soni

et al. 2017

CEN Case Rep

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Rhabdomyolysis is characterized by the acute breakdown of skeletal muscle, resulting in the release of muscle cell contents, subsequent myoglobinuria, and in severe cases, acute renal failure. A number of etiologies have been identified in acute rhabdomyolysis, in which drugs and trauma account for the majority of cases. One etiological category that is commonly overlooked in the adult population is an underlying genetic defect. This may be challenging to diagnose due to its rarity in the adult demographic and the marked heterogeneity, often requiring a high level of clinical suspicion before investigation is pursued. Once diagnosed, however, appropriate steps can be taken to reduce future episodes of rhabdomyolysis, further renal injury, and other systemic complications. Here, we report a case of an adult patient presenting with acute rhabdomyolysis secondary to McArdle disease, a genetic disease causing defective glycogenolysis. The case highlights the importance of recognizing the potential of undiagnosed ''pediatric'' disorders in adulthood and particularly for underlying genetic causes of rhabdomyolysis.

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McArdle disease: a “pediatric” disorder presenting in an adult with acute kidney injury

Zhao

Soni

et al. 2017

CEN Case Rep

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Teens and Spice: A Review of Adolescent Fatalities Associated with Synthetic Cannabinoid Use

Paul

Simms²,

Amini

et al. 2017

Journal of Forensic Sciences

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Synthetic cannabinoids (SCs) are commonly abused by adolescents with reported past year (2013) use in high school students between 3 and 10%. Standard adolescent postmortem toxicology does not include routine SC analysis, and thus, the true burden of fatalities related to SCs is unknown. A retrospective case review of two cases included scene investigation, interviews, autopsy, and toxicology. SCs were confirmed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Review of the eight adolescent SC-associated fatalities in the literature revealed five of eight cases had no other discernible cause of death on autopsy. Compounds detected included PB-22 (1.1 ng/mL), JWH-210 (12 ng/mL), XLR-11 (1.3 ng/mL), JWH-122, AB-CHMINACA (8.2 ng/mL), UR-144 (12.3 ng/mL), and JWH-022 (3 ng/mL). With synthetic drug use on the rise, forensic experts should have a high index of suspicion for the possibility of SC intoxication in adolescent fatalities with no other discernible cause of death.

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Phantom menace: novel psychoactive substances and the UK Armed Forces

Hunter

Ayres

Moreland³

et al. 2018

J R Army Med Corps

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Novel psychoactive substances (NPS) encompass a large group of synthesised compounds specifically designed to mimic traditional recreational drugs. Current UK Armed Forces compulsory drug testing does not screen for these substances, making them tempting to the small proportion of UK Armed Forces personnel who indulge in recreational drug use. The acute and chronic sequelae of NPS misuse are widely variable and associated with high morbidity. In this paper, we discuss NPS pharmacology and clinical presentation. We describe toxidromes and management of patients who have misused NPS.Finally, we reflect on the legal, ethical and military consequences of NPS misuse for both the service person misusing NPS and the Military Physician providing their care.

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Not safe for consumption: Synthetic cannabinoids causing fatal acute rhabdomyolysis in two young men

Cited by 4 publications

References 8 publications

McArdle disease: a “pediatric” disorder presenting in an adult with acute kidney injury

McArdle disease: a “pediatric” disorder presenting in an adult with acute kidney injury

Teens and Spice: A Review of Adolescent Fatalities Associated with Synthetic Cannabinoid Use

Phantom menace: novel psychoactive substances and the UK Armed Forces

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