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Prolonged Coma in a Child Due to Hashish Ingestion with Quantitation of THC Metabolites in Urine

      Abstract

      Background

      Cannabinoid-containing substances are commonly abused worldwide. Significant toxicity from these substances is uncommon in adults but can result in significant symptoms in children; these symptoms are usually short-lived.

      Objectives

      To report a case of prolonged mental status alteration of more than 2 days in a child who ingested hashish.

      Case Report

      A 14-month-old child presented comatose to a pediatric emergency department after ingestion of hashish; she did not regain consciousness for more than 48 h. Quantitative testing of the child’s urine for a tetrahydrocannabinol metabolite revealed a markedly elevated level, the decline of which coincided with the child’s clinical improvement.

      Conclusions

      Significant ingestion of cannabinoid-containing substances is capable of causing prolonged symptoms (including coma) in children.

      Keywords

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      References

        • Weinberg D.
        • Lande A.
        • Hilton N.
        • Kerns D.L.
        Intoxication from accidental marijuana ingestion.
        Pediatrics. 1983; 71: 848-850
        • Boros C.A.
        • Parsons D.W.
        • Zoanetti G.D.
        • Ketteridge D.
        • Kennedy D.
        Cannabis cookies: a cause of coma.
        J Paediatr Child Health. 1996; 32: 194-195
        • Appelboam A.
        • Oades P.J.
        Coma due to cannabis toxicity in an infant.
        Eur J Emerg Med. 2006; 13: 177-179
        • Johnson D.
        • Conradi A.
        • McGuigan M.
        Hashish ingestion in toddlers.
        Vet Hum Toxicol. 1991; 33 ([abstract]): 393
        • Macnab A.
        • Anderson E.
        • Susak L.
        Ingestion of cannabis: a cause of coma in children.
        Pediatr Emerg Care. 1989; 5: 238-239
        • McLaren J.
        • Swift W.
        • Dillon P.
        • Allsop S.
        Cannabis potency and contamination: a review of the literature.
        Addiction. 2008; 103: 1100-1109
        • Licata M.
        • Verri P.
        • Beduschi G.
        Delta9 THC content in illicit cannabis products over the period 1997–2004 (first four months).
        Ann Ist Super Sanita. 2005; 41: 483-485
        • Rubio F.
        • Quintero S.
        • Hernandez A.
        • et al.
        Flumazenil for coma reversal in children after cannabis.
        Lancet. 1993; 341: 1028-1029
        • Kemp P.M.
        • Abukhalaf I.K.
        • Manno J.E.
        • et al.
        Cannabinoids in humans. II. The influence of three methods of hydrolysis on the concentration of THC and two metabolites in urine.
        J Anal Toxicol. 1995; 19: 292-298