Shahbaz Amir, Gaviria Rafael Eduardo Eee, Shahid Muhammad Faizan, Yasin Muhammad Awais, Ashraf Attique, Zaman Muhammad A
Internal Medicine, Icahn School of Medicine at Mount Sinai/Queens Hospital Center, New York, USA.
Medicine, Saint Agnes Hospital, Baltimore, USA.
Cureus. 2018 Sep 4;10(9):e3257. doi: 10.7759/cureus.3257.
Synthetic cannabinoid abuse can manifest with an array of unpredictable reactions ranging from sedation to hallucinations, psychosis, and seizures. Acute liver injury associated with the synthetic cannabinoid use is a rare complication. We present a case of a 22-year-old homeless male presented with abdominal pain and vomiting. He admitted regular synthetic cannabinoid use, and binge alcohol use once a week. Physical examination was remarkable only for mild icterus. The laboratory result shows abnormal liver functions tests. Viral, autoimmune, metabolic and other toxic etiologies of liver injury were ruled out. The acute liver injury was deemed to be secondary to synthetic cannabinoids toxicity. Spice-induced liver injury remains a diagnosis of exclusion after all other identifiable causes ruled out. Clinicians should have a high index of suspicion for synthetic cannabinoid abuse in a patient with acute hepatotoxicity who had a history of polysubstance abuse.
合成大麻素滥用可表现出一系列不可预测的反应，从镇静到幻觉、精神病和癫痫发作。与使用合成大麻素相关的急性肝损伤是一种罕见的并发症。我们报告一例22岁无家可归男性，表现为腹痛和呕吐。他承认经常使用合成大麻素，且每周有一次酗酒。体格检查仅发现轻度黄疸。实验室检查结果显示肝功能试验异常。排除了肝损伤的病毒、自身免疫、代谢及其他毒性病因。急性肝损伤被认为是合成大麻素毒性所致。在排除所有其他可识别的病因后，香料诱导的肝损伤仍是一种排除性诊断。对于有急性肝毒性且有多物质滥用史的患者，临床医生应高度怀疑合成大麻素滥用。
