Rhabdomyolysis and Renal Insufficiency Due to Synthetic Cannabinoid Intoxication

Bonsai, which is the street name of synthetic marijuana is a psychoactive substance. Since synthetic cannabinoids (SC) are easily accessible and cheap, their use is becoming widespread day by day. Cannabinoids are lipid soluble and non-polar, and consist of 22 to 26 carbon structure/atoms (1). Also they easily evaporate when smoked. These SC effects are carried out through CB1 and CB2 receptors and the active ingredient is delta-9-tetrahydrocannabinol (THC). While CB1 receptors are responsive from the psychoactive component of cannabinoids, the CB2 receptors control the release of cytokines and the migration of immune cells (2,3). The use of SC causes mental status changes, seizures, central nervous system depression, hallucinations, anxiety, and vivid dreams (4). In the literature, there have been cases that developed rhabdomyolysis depending on the use of SC. However, the number of cases that was monitored and treated with consecutive plasma exchange therapy (PET) and hemodialysis treatment are quite a few (5-7). ABSTRACT Bonsai is the street name of synthetic marijuana, which is a psychoactive substance. Since synthetic cannabinoids are easily accessible and cheap, their use is becoming widespread day by day. It can cause not only various clinical symptoms but also severe rhabdomyolysis. In this case, with severe rhabdomyolysis, we tried to discuss the treatment challenges of the patient examined in intensive care unit with the history of bonsai use.