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Pediatric Death Due to Myocarditis After Exposure to Cannabis
Thomas M Nappe1, Christopher O Hoyte1,2
1Denver Health and Hospital Authority, Rocky Mountain Poison and Drug Center, Denver, Colorado.
Insights
Pediatric cannabis exposure may be linked to sudden cardiac death. An 11-month-old infant died from myocarditis after exposure, suggesting a potential causal relationship warranting clinical awareness.
Area of Science:
- Toxicology
- Pediatric Cardiology
- Forensic Pathology
Background:
- Pediatric cannabis exposure has risen post-legalization.
- No prior pediatric deaths attributed to cannabis exposure were reported.
- Cannabis is increasingly available in commercial and decriminalized markets.
Observation:
- An 11-month-old male experienced central nervous system depression and seizure post-cannabis exposure.
- The infant progressed to cardiac arrest and death.
- Post-mortem examination revealed myocarditis, with confirmed cannabis exposure.
Findings:
- A potential association between pediatric cannabis exposure and fatal myocarditis is suggested.
- Histological findings were consistent with drug-induced myocarditis.
- No alternative causes for myocarditis were identified.
Implications:
- Clinicians should consider cannabis exposure in pediatric myocarditis cases.
- Preventive counseling for parents regarding cannabis risks is crucial.
- This case highlights the potential for severe adverse events in pediatric cannabis exposure.
Abstract:
Since marijuana legalization, pediatric exposures to cannabis have increased.1 To date, pediatric deaths from cannabis exposure have not been reported. The authors report an 11-month-old male who, following cannabis exposure, presented with central nervous system depression after seizure, and progressed to cardiac arrest and died. Myocarditis was diagnosed post-mortem and cannabis exposure was confirmed. Given the temporal relationship of these two rare occurrences - cannabis exposure and sudden death secondary to myocarditis in an 11-month-old - as well as histological consistency with drug-induced myocarditis without confirmed alternate causes, and prior reported cases of cannabis-associated myocarditis, a possible relationship exists between cannabis exposure in this child and myocarditis leading to death. In areas where marijuana is commercially available or decriminalized, the authors urge clinicians to preventively counsel parents and to include cannabis exposure in the differential diagnosis of patients presenting with myocarditis.
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