Ci bastan poche briciole, lo stretto indispensabile: intossicazione accidentale da Tetraidrocannabinolo in età pediatrica

In the last few years, paediatric exposure to illicit substances such as tetrahydrocannabinol (THC) and other cannabinoid derivatives has increased dramatically. Specifically, 97.7% of exposures occur at home, mainly due to accidental ingestion of edible industrial products, such as candy or cookies, or of discarded illicit products consumed at home. The average age of exposure is 17 months, and the symptoms are mainly neurological, such as lethargy and drowsiness (70% of cases), hypotonia and ataxia. 22.7% of THC intoxications require hospitalisation, with 8-18% of cases requiring intensive care. Severe complications include coma, respiratory depression with apnoea and need for intubation (6%), convulsions, cardiovascular instability and arrhythmias. Considering these data, it is essential to include the THC intoxication in the diagnostic-therapeutic algorithm for patients presenting with acute neurological symptoms, in particular lethargy. Therefore, the suspected diagnosis must be guided by a careful medical history in order to confirm the clinical suspicion and avoid administering drugs that could worsen the clinical presentation. The clinical case described reports the diagnostic process and the clinical management of a two-year-old patient arrived at the emergency room with acute neurological symptoms (specifically lethargy), due to incidental ingestion of THC.

Un bambino di 20 mesi è stato condotto al Pronto Soccorso per l’insorgenza acuta di letargia, pianto inconsolabile e ridotta interazione ambientale. Nonostante i parametri vitali stabili, l’esame neurologico ha evidenziato atassia (deambulazione incerta) e midriasi. A fronte di esami ematici ed ECG normali, il sospetto clinico ha orientato i medici verso uno screening tossicologico, che è risultato positivo per il tetraidrocannabinolo (THC). Il bambino è stato ricoverato in Medicina d’Urgenza, dove ha mostrato un rapido miglioramento fino al completo ripristino delle funzioni neuro-cognitive. Data la natura dell’evento, sono state attivate le procedure legali e i servizi sociali.