用N-乙酰半胱氨酸治疗香料/K2合成大麻所致中毒性肝炎。
Spice/K2 synthetic marijuana-induced toxic hepatitis treated with N-acetylcysteine.
作者信息
Sheikh Israr A, Lukšič Miha, Ferstenberg Richard, Culpepper-Morgan Joan A
机构信息
Division of Gastroenterology, Department of Medicine, Columbia University, Harlem Hospital Center, New York, USA.
Faculty of Chemistry and Chemical Technology, University of Ljubljana, Ljubljana, Slovenia.
出版信息
Am J Case Rep. 2014 Dec 30;15:584-8. doi: 10.12659/AJCR.891399.
BACKGROUND
Spice/K2 is one of several street names for synthetic marijuana. These hallucinogens are increasingly sold over the internet and in "head" shops. They are usually household herbs that are sprayed with chemicals that become centrally active compounds when burned together and inhaled by smoking.
CASE REPORT
We present a case of a 45-year-old male substance abuser who was admitted with evidence of hepatocellular necrosis and worsening liver failure. Tests for acetaminophen were negative, as were tests for alcohol. The patient was empirically treated with N-acetylcysteine. Hepatocellular damage was abated and the patient made a full recovery. Upon regaining consciousness, the patient admitted to smoking Spice/K2. Other toxicities have been reported with synthetic marijuana use, but not liver toxicity.
CONCLUSIONS
Physicians need to have a high index of suspicion for unknown hepatotoxins in substance abusers. N-acetylcysteine can be given if there is no contraindication.
背景
香料/K2是合成大麻的几种街头名称之一。这些致幻剂在互联网上和“烟具”店越来越多地被售卖。它们通常是家用草药，被喷洒了化学物质，这些化学物质在与草药一起燃烧并通过吸烟吸入时会变成具有中枢活性的化合物。
病例报告
我们报告一例45岁男性药物滥用者，因肝细胞坏死和肝功能衰竭恶化入院。对乙酰氨基酚检测呈阴性，酒精检测也呈阴性。该患者接受了N-乙酰半胱氨酸的经验性治疗。肝细胞损伤得到缓解，患者完全康复。恢复意识后，患者承认吸食过香料/K2。使用合成大麻还报告了其他毒性，但未报告肝脏毒性。
结论
医生需要对药物滥用者中未知的肝毒素保持高度怀疑。如果没有禁忌证，可以给予N-乙酰半胱氨酸。
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