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Pediatric gamma hydroxybutyrate intoxication

S Suner1, C S Szlatenyi, R Y Wang

  • 1Brown University School of Medicine, Providence, RI, USA. selim_suner@brown.edu

Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
|December 31, 1997
PubMed
Summary
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Two children experienced gamma hydroxybutyrate (GHB) toxicity after ingesting a homemade drink. This highlights the dangers of clandestine GHB production and its potential presence in households.

Area of Science:

  • Toxicology
  • Pediatric Medicine
  • Forensic Chemistry

Background:

  • Gamma hydroxybutyrate (GHB) is a central nervous system depressant.
  • Clandestine synthesis of GHB poses significant public health risks.
  • Accidental pediatric exposure to GHB is uncommon but dangerous.

Observation:

  • Two children presented with sudden onset coma after unintentional ingestion of a GHB-containing beverage.
  • The GHB was synthesized at home by a parent using gamma-butyrolactone and sodium hydroxide.
  • Clinical presentation included rapid onset of symptoms and resolution within 24 hours.

Findings:

  • Electrocardiogram (ECG) abnormalities were observed in one child, unique to GHB toxicity and currently unexplained.
  • Pediatric GHB toxicity mirrors clinical manifestations seen in adult cases.

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  • Standard drug screening assays do not detect GHB.

    • Implications:

    • Healthcare providers must be aware of the clandestine production and increasing availability of GHB.
    • Prompt recognition and supportive care are crucial for managing pediatric GHB toxicity.
    • The potential for household synthesis necessitates increased vigilance regarding substance safety.