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Synthetic cannabinoids revealing adrenoleukodystrophy.
Avi Fellner1, Felix Benninger1, Ruth Djaldetti1
1Department of Neurology, Rabin Medical Center, Beilinson Hospital, 39 Jabotinski Street, Petah Tikva 49100, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Summary
Synthetic cannabinoid use may trigger seizures and worsen underlying conditions like adrenoleukodystrophy in susceptible individuals. This case highlights potential metabolic decompensation linked to drug use.
Area of Science:
- Neurology
- Metabolic disorders
- Genetics
Background:
- Adrenoleukodystrophy (ALD) is a rare genetic disorder affecting the white matter of the brain and adrenal glands.
- Synthetic cannabinoids are psychoactive substances with varied and often unpredictable effects.
Observation:
- A 41-year-old man experienced a generalized tonic-clonic seizure after using a synthetic cannabinoid.
- Brain MRI revealed extensive bilateral white matter lesions, predominantly in the frontal lobes.
Findings:
- Blood analysis indicated elevated very long chain fatty acids, consistent with adrenoleukodystrophy.
- Genetic testing confirmed a missense mutation in the ABCD1 gene, definitively diagnosing adrenoleukodystrophy.
Implications:
- The findings suggest that synthetic cannabinoid consumption may precipitate metabolic decompensation in individuals with pre-existing adrenoleukodystrophy.
- This case underscores the potential for drug-induced exacerbation of underlying genetic metabolic disorders.
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