
Pediatric Death Due to Myocarditis After Exposure to Cannabis - jasonmp85
https://escholarship.org/uc/item/1n10w5pc
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lubujackson
So 1 baby dies and because myocarditis is rare and they assume "cannabis
exposure" is rare that they are probably linked? This seems pretty far from
anything like science.

~~~
joshgel
This is exactly how science works.

They report this possible case. Maybe there is never another association and
the issue is forgotten, because there is no causal link. But maybe, someone
else, some place else, who never read this paper, notices something similar
and reports it. And maybe this happens several more times. And then, along the
way, one of these reporters does a detailed search and finds the other
reports. He collects the cases and maybe contacts the doctors who wrote the
reports and writes what we call a Case-Series on these.

Maybe a couple case-series get written independently in various places.
Someone finds these series and convinces someone else to fund a Case Control
study.

Usually with environmental exposure literature this is exactly how "science"
happens. Medicine is messy and serendipity is more than involved.

Hierarchy of evidence:
[http://ebm.bmj.com/content/early/2016/06/23/ebmed-2016-11040...](http://ebm.bmj.com/content/early/2016/06/23/ebmed-2016-110401)

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mistersquid
The implication this infant died of myocarditis due to cannabis exposure is
horrifying. If I'm reading correctly, the cause of myocarditis is unclear but
the association is confirmed.

Which leads me to wonder what was the mechanism of exposure? Was the infant
given something to eat, inhale, or something worse (if such a thing is
possible)?

I'm struggling to believe that this infant's caregivers did not knowingly dose
this infant with cannabis.

~~~
maxander
There's no story from the parents as to what happened. The closest the paper
gives to explaining the situation directly is at the end of the Case Report:
"Additional history disclosed an unstable motel-living situation and parental
admission of drug possession, including cannabis."

In the midst of the toxicological analysis, it mentions that the THC
metabolites they observe were "most likely secondary to ingestion" and it
later says, given that they observed various metabolites but not the primary
compound itself, "the authors deduce that cannabis consumption occurred within
the recent two to six days, assuming this was a single, acute high-potency
ingestion."

So, most likely what happened is that the parents carelessly left some edibles
around, and the infant toddled over and put one in his mouth. Infants put
_everything_ in their mouths, so an accidental exposure sounds plausible-
albeit criminally negligent. I'd presume the parents have been charged
accordingly.

~~~
mistersquid
Thank you for replying with that information. I read the article but didn't
see the "Additional history" note.

I also poorly worded the last paragraph of my previous comment. What I meant
to say was more along the lines of "I want to believe this infant's caregivers
did not knowingly dose this infant."

Negligence is bad but not nearly so bad and dispiriting as intentional
exposure gone awry.

(Disclosure: I support medical and recreational cannabis for consenting
adults.)

EDIT: spelling, disclosure.

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yehosef
I'm sorry but this is really not science. This is the scientific equivalent of
"and you'll never believe what happened next...".

Do a search for "Pediatric Myocarditis" and you'll see lots of results - it
happens, unfortunately. I think it's far more likely that it's caused by a
vaccination ([http://www.vaxchoicevt.com/myocarditis-after-
vaccination/](http://www.vaxchoicevt.com/myocarditis-after-vaccination/)) or
one of the other causes mentioned here:
[https://emedicine.medscape.com/article/897591-overview](https://emedicine.medscape.com/article/897591-overview)

~~~
lvh
Detailed reports of observations are important, normal portions of the
scientific process. They're just the first step. Where is the line? Is a
hypothesis with an experiment design not science? Is a negative finding not
science? Is a positive self-reported study not science? Is a positive double-
blind study also not science (because it hasn't been repeated)?

Being dismissive of preliminary findings as "not science" is the same kind of
attitude that cause people to not publish negative results, which is an
incredible tragedy of modern scientific progress.

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MBlume
Worth noting that this is a case study about one child. I'm not saying the
science is bad or that you should blow cannabis smoke in your baby's face, but
if the headline made you think there's an epidemic of babies dying due to
exposure to cannabis, that's not the case.

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stretchwithme
I think its sad people are using drugs when they have responsibility for a
child.

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ghufran_syed
This is ridiculous, "post hoc, ergo propter hoc" [1]

[1]
[https://en.wikipedia.org/wiki/Post_hoc_ergo_propter_hoc](https://en.wikipedia.org/wiki/Post_hoc_ergo_propter_hoc)

~~~
jey
No, it's a case report. They looked for more normal causes of myocarditis and
didn't find any. Note that they only claim an association, not that it
directly definitely caused it.

It seems very plausible that cannabis is toxic to infants in ways that it
wouldn't affect adults.

Here's a quote of the relevant part of the abstract:

> histological consistency with drug-induced myocarditis without confirmed
> alternate causes, and prior reported cases of cannabis-associated
> myocarditis, a possible relationship exists between cannabis exposure in
> this child and myocarditis leading to death

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orliesaurus
Mmh so this seems just a coincidence and they re saying it's happened because
of cannabis?

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Finnucane
No, they’re saying they’ve seen enough evidence to report to other doctors to
keep an eye out for it. Reports of this nature are not unusual in medicine,
someone just noticed this one because of the drug connection.

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blunte
I'm sorry. Of the millions of babies who die within their first year globally,
I find it hard to be suddenly concerned about cannabis's effect on them given
the multitude of other factors.

That's not to say it isn't worth study, but it's unlikely worth a headline.

~~~
inpdx
Whenever there's anything negative even possibly associated with cannabis,
there are those who must reflexively shoot it down, or minimize it (i.e. your
data is wrong, or, if it's not wrong, it's not as bad as alcohol, or if it is,
it's a rare issue). It's like they can't accept that cannabis could ever be
bad for any reason. I find this very odd.

~~~
dugword
Because negative news articles about cannabis are almost always flimsy studies
trying to spread fear and push an agenda.

If cannabis was legal everywhere almost no one would care about these studies.

However, cannabis is illegal in most places and there is a battle for opinions
where groups are trying to spread FUD about how "weed is killing babies".

It's fighting for people to have a rational stance and pushing for policies
that don't imprison people over a substance on par with alcohol that brings
out the defenders on any article like this.

