Neutrophil to Lymphocyte ratio of Synthetic Cannabinoid Intoxication

Abstract

Synthetic cannabinoids represent an in-creasingly popular trend, and acute intoxi-cation is widely seen in emergency rooms and intensive care units (ICU), as they are inexpensive and easily accessible. Cannab-inoids mediate their effects through bind-ing specific receptors which are members of the G protein coupled receptor super-family. Cannabinoid-2 receptors are pri-marily found in the immune system and mediate immunosuppression by inducing apoptosis, inhibition of proliferation and suppression of cytokine and chemokine production. Many studies have discussed the effects of cannabinoids on the hema-tological and immune systems but con-troversial results have been reported. The aim of this study was to identify laboratory findings of acute synthetic cannabinoid in-toxication. Forty-two patients, admitted to the ‘Anesthesia intensive care unit’ between 2014 and 2015 with synthetic cannabinoid intoxication, were studied retrospectively to assess the relationship between synthet-ic cannabinoid intoxication and complete blood count (white blood cells (WBC), neutrophils, lymphocytes, monocytes, eosinophils, basophils) and neutrophil to lymphocyte ratio. WBC neutrophil count decreased at ICU discharge when com-pared to ICU admission (p<0.001). The ra-tio of neutrophils to lymphocytes was also lower at ICU discharge when compared to ICU admission (p<0.05).