Session Title: Virtual Poster Hall
Session Time: None. Available on demand.
Disclosures: Andrew J. Duarte, MD: No financial relationships or conflicts of interest
Case Description: A 52 year old male with Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) caused by K2, a synthetic cannabinoid.
Setting: Quaternary care, academic medical center
Patient: The patient is a 52 year old male with a past medical history of schizoaffective disorder, polysubstance abuse, and hepatitis C who presented to the emergency department with a chief complaint of progressive lower extremity weakness over a 5 day period. In the ED his exam was notable for bilateral lower extremity paraparesis and areflexia. Assessment/
Results: He was admitted to the hospital where his work up included an unremarkable brain MRI and a lumbar puncture which was notable for albuminocytologic dissociation. At that time, he was diagnosed with AIDP, completed 5 days of IVIG, and transitioned to inpatient rehabilitation. An electromyographic study that was performed during his rehab stay, 18 days after his symptoms began, confirming AIDP by revealing motor as well as sensory demyelinating polyneuropathy. Follow up study performed 6 weeks later corroborated this finding with additional signs of motor axonal degeneration in upper and lower extremity muscles, consistent with the clinical diagnosis of CIDP.
Discussion: CIDP is an immune mediated demyelinating polyneuropathic disorder. When symptoms persist for more than 6 weeks, and EMG demonstrates secondary axonal features, CIDP is confirmed. It is important to distinguish CIDP from AIDP as there are additional treatments for CIDP beyond the initial IVIG course including immunosuppressive regimens, anti-thymocyte globulin, and even hematopoietic stem cell transplant. Per his history, the only identifiable trigger for his CIDP is K2: a synthetic cannabis product that is known to be much more potent then conventional cannabis.
Conclusion: K2 can cause CIDP, given the ongoing legal and cultural discussions regarding the legalization of cannabis products, this case highlights that cannabis use is not without risk.
Level of Evidence: Level V
To cite this abstract in AMA style:Duarte AJ. Synthetic Cannabinoid Resulting in Chronic Inflammatory Demyelinating Polyneuropathy [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/synthetic-cannabinoid-resulting-in-chronic-inflammatory-demyelinating-polyneuropathy/. Accessed July 30, 2021.
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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/synthetic-cannabinoid-resulting-in-chronic-inflammatory-demyelinating-polyneuropathy/