From Euphoria to Emergency: Exploring the Role of K2/Spice in Diffuse Alveolar Hemorrhage

Abstract

Marijuana or cannabis has been one of the most widely used recreational drugs, in the United States. However, a sinister counterpart has emerged in recent times: K2/Spice, a synthetic rendition of tetrahydrocannabinol (THC), capturing increasing popularity. Alarming reports have linked this synthetic compound to a multitude of life-threatening complications, ranging from acute kidney injury (AKI) from direct nephrotoxicity to cardiac arrest. Here we present the case of a 34-year-old man who presented with hemoptysis, later found to have diffuse alveolar hemorrhage (DAH) on the investigation after smoking K2/Spice successfully treated with a course of intravenous steroids. The case presented underscores the urgent need for increased awareness about the potential complications associated with synthetic compounds like K2/Spice, such as diffuse alveolar hemorrhage, and the importance of developing effective treatment strategies.

Keywords: acute respiratory distress syndrome (ards); bilateral pulmonary infiltrates; cannabis use; diffuse alveolar hemorrhage; e-cigarette and vaping product use associated lung injury (evali); hemoptysis; k2/spice; lung injury; synthetic cannabinoids; synthetic cannabis.

Figure 1. X-ray chest AP view of the chest showing areas of consolidation. Black arrows showing areas of consolidation.

Figure 2. CT chest with contrast showing multiple diffuse ground-glass opacities. Black arrows showing ground-glass opacities.

Figure 3. Bronchoscopy showing no active source of bleeding and mucoid serosanguineous secretions.

Panel 1: Trachea, Panel 2: Right upper lobe, Panel 3: Right middle lobe, Panel 4: Right lower lobe, Panel 5: Left mainstem bronchus, and Panel 6: Left lower lobe.

Figure 4. X-ray chest on day six of admission showing resolution of bilateral opacities.