Cannabis intoxication after accidental ingestion in infants: urine and plasma concentrations of Δ-9-tetrahydrocannabinol (THC), THC-COOH and 11-OH-THC in 10 patients

Clin Toxicol (Phila). 2020 May;58(5):421-423. doi: 10.1080/15563650.2019.1655569. Epub 2019 Aug 23.

Abstract

Introduction: Accidental cannabis poisoning after oral ingestion in infants is an emerging cause of intoxication with well-known clinical aspects but few data exist regarding the levels of cannabinoids in plasma and urine. Here, we present data on the concentrations of Δ-9-tetrahydrocannabinol (THC) and metabolites in plasma and/or urine in 10 infants after cannabis intoxication.Materials and methods: Cannabinoids were detected using an automated immunochemical method and quantified using liquid chromatography coupled with mass spectrometry.Results: Ten infants were admitted after cannabis poisoning. THC, THC-COOH and 11-OH-THC plasma levels ranged from 4.4 to 127 ng/mL, from 28 to 433 ng/mL and from 2 to 59.8 ng/mL, respectively. THC-COOH urine levels ranged from 748 to 5689 ng/mL. The most common symptoms were drowsiness, hypotonia, behavioural disorder and tachycardia.Discussion: No correlation between plasma concentrations and symptoms could be found, but the concentration of THC-COOH in the two patients who experienced seizures was higher than 3000 ng/mL. This series of cases of accidental intoxication in infants showed high THC and metabolites concentrations in urine and plasma.

Keywords: Cannabis; infants; intoxication; quantification.

MeSH terms

  • Cannabis / poisoning*
  • Chromatography, Liquid / methods
  • Dronabinol / analogs & derivatives*
  • Dronabinol / blood*
  • Dronabinol / urine
  • Female
  • Gas Chromatography-Mass Spectrometry / methods
  • Humans
  • Infant
  • Male

Substances

  • 11-hydroxy-delta(9)-tetrahydrocannabinol
  • Dronabinol
  • delta(9)-tetrahydrocannabinolic acid