Abstract | CONTEXT: Despite widespread use of diverse synthetic cannabinoid (sCB) compounds, the pathophysiology associated with intoxication with many sCB compounds, including AB-CHMINACA, is poorly understood, as is their metabolism and distribution into blood and organs. CASE DETAILS: A young man died shortly after ingesting an herb product containing sCB compounds. Toxicological analyses of blood samples revealed high levels of AB-CHMINACA (7.61 ± 0.59 ng/mL) and its metabolites (M2, 56.73 ± 4.16 ng/mL; M4, 2.29 ± 0.14 ng/mL) and trace amounts of 5-fluoro-AMB, FUB-PB-22, and AB-FUBINACA. The autopsy revealed severe pulmonary edema, and histology showed air bubbles in the alveolar effusion, suggesting rapid progression of edema. Low blood levels of N-terminal pro- brain natriuretic peptide excluded cardiogenic pulmonary edema. Histological examination revealed diffuse neuronal (brain) and myocardial (sub-endocardial) hyper- eosinophilia, indicating hypoxic encephalopathy and systemic hypoxemia, respectively. CONCLUSIONS:
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Authors | Hideyuki Maeda, Ruri Kikura-Hanajiri, Maiko Kawamura, Erika Nagashima, Ken-Ichi Yoshida |
Journal | Clinical toxicology (Philadelphia, Pa.)
(Clin Toxicol (Phila))
Vol. 56
Issue 2
Pg. 143-145
(02 2018)
ISSN: 1556-9519 [Electronic] England |
PMID | 28707493
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Cannabinoids
- Designer Drugs
- Indazoles
- Valine
- N-(1-(aminocarbonyl)-2-methylpropyl)-1-(cyclohexylmethyl)-1H-indazole-3-carboxamide
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Topics |
- Adult
- Autopsy
- Brain
(pathology)
- Brain Stem
(pathology)
- Cannabinoids
(poisoning)
- Death, Sudden
(etiology)
- Designer Drugs
(poisoning)
- Fatal Outcome
- Humans
- Hypoxia, Brain
(chemically induced, pathology)
- Indazoles
(poisoning)
- Male
- Myocardium
(pathology)
- Pulmonary Edema
(chemically induced, pathology)
- Valine
(analogs & derivatives, poisoning)
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