Refractory Status Epilepticus, Serotonin Syndrome, and Fulminant Multiorgan Failure Following Synthetic Cannabinoid Vaping: A Case Report
A 17-year-old developed refractory status epilepticus, serotonin syndrome, and multiorgan failure after synthetic cannabinoid vaping, highlighting rare complications despite negative toxicology screening.Summary
This case report describes a previously healthy 17-year-old male who developed refractory status epilepticus, serotonin syndrome, and fulminant multiorgan failure following inhalation of a synthetic cannabinoid (SC) vape. After a first seizure, he experienced recurrent seizures requiring aggressive sedation with midazolam, propofol, and other anticonvulsants. Upon sedation withdrawal, he met Hunter criteria for serotonin syndrome. Subsequent complications included acute kidney injury, cardiogenic shock requiring VA-ECMO, severe rhabdomyolysis, and persistent hypoglycemia. Brain MRI revealed an ischemic stroke in the left putamen. The patient recovered neurologically after 31 days. The report emphasizes the importance of early recognition of SC toxicity, as routine toxicology screens often fail to detect these substances. Mechanisms underlying the multiorgan toxicity remain speculative, with SCs' full CB1 receptor agonism and structural differences from natural cannabinoids implicated in severe adverse effects.
(Source：Google News)
