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Risk Factors and Clinical Correlates of Pediatric Serotonin Syndrome in Hospitalized Suicide Attempters

Susheel K Khetarpal1,2, Manivel Rengasamy1,3, Ololade Adebiyi1,4

  • 1University of Pittsburgh School of Medicine, Pittsburgh, PA.

The Journal of Pediatrics: X
|June 19, 2023
PubMed

Insights

Pediatric serotonin syndrome (SS) is linked to marijuana use and SSRI overdose. Affected children require longer medical stabilization and ventilation. Hunter's criteria show poor sensitivity for diagnosing pediatric SS.

Area of Science:

  • Pediatric Toxicology
  • Clinical Pharmacology
  • Emergency Medicine

Background:

  • Limited research exists on pediatric serotonin syndrome (SS), unlike adult cases.
  • Understanding risk factors and clinical outcomes in children is crucial for timely diagnosis and treatment.

Purpose of the Study:

  • To identify risk factors and clinical correlates of pediatric SS.
  • To evaluate the diagnostic accuracy of Hunter's criteria in pediatric patients.

Main Methods:

  • Retrospective chart review of 183 pediatric patients hospitalized after a suicide attempt.
  • Analysis of associations between SS, risk factors, and clinical outcomes.
  • Assessment of sensitivity and specificity of Hunter's criteria and criterion symptoms.

Main Results:

  • Serotonin syndrome (SS) occurred in 21.7% of patients with serotonergic overdose.
  • Recent marijuana use and selective serotonin reuptake inhibitor (SSRI) overdose were significant risk factors.
  • SS patients required longer medical stabilization and had increased likelihood of ventilation.
  • Hunter's criteria demonstrated 66.7% sensitivity and 92.3% specificity.

Conclusions:

  • Novel risk factors (e.g., marijuana use) and clinical correlates for pediatric SS were identified.
  • Hunter's criteria exhibit good specificity but poor sensitivity for diagnosing SS in children.
  • Further research is needed to improve early identification and treatment of pediatric SS.
Abstract

Keywords:
adolescentoverdosepediatricserotonin syndromesuicide attempt

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