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Gamma-hydroxybutyrate poisoning from toy beads

Naren Gunja1, Evelyn Doyle, Kevin Carpenter

  • 1NSW Poisons Information Centre, The Children's Hospital at Westmead, Sydney, NSW, Australia. NarenG@chw.edu.au

The Medical Journal of Australia
|November 21, 2007
PubMed

Insights

Two children experienced decreased consciousness after ingesting toy beads. The beads contained 1,4-butanediol, which the body converts to gamma-hydroxybutyrate (GHB), leading to a product recall.

Area of Science:

  • Toxicology
  • Pediatric Emergency Medicine
  • Consumer Product Safety

Background:

  • Gamma-hydroxybutyrate (GHB) is a central nervous system depressant with potential for abuse.
  • Accidental ingestion of toxic substances in children is a significant public health concern.
  • The metabolism of precursor chemicals to GHB can lead to unexpected toxicity.

Observation:

  • Two pediatric patients presented with altered mental status, including decreased consciousness.
  • One patient experienced persistent vomiting and a seizure.
  • Urine metabolic screening revealed elevated levels of gamma-hydroxybutyrate (GHB).

Findings:

  • Toy beads ingested by the children were analyzed and found to contain 1,4-butanediol.
  • 1,4-butanediol is a known precursor that is metabolized to gamma-hydroxybutyrate (GHB) in the human body.
  • The clinical presentation was consistent with gamma-hydroxybutyrate (GHB) toxicity.

Implications:

  • This case highlights the potential danger of consumer products containing hidden toxic precursors.
  • Prompt identification of the toxic agent and its metabolic pathway was crucial for patient management.
  • The findings led to regulatory action, including an international recall of the contaminated toy beads, preventing further exposures.

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