γ-Hydroxybutyrate poisoning from toy beads

Naren Gunja, Evelyn Doyle , Kevin Carpenter, Olivia T Chan, Simon Gilmore, Gary Browne and Andis Graudins
Med J Aust 2008; 188 (1): 54-55.

A 2-year-old boy and a 10-year-old girl presented to the emergency department with a decreased level of consciousness. The girl had had persistent vomiting and a seizure. Urine metabolic screening tests were positive for γ-hydroxybutyrate (GHB). Samples from toy beads ingested by both children contained 1,4-butanediol, which is metabolised to GHB in humans. Regulatory authorities were notified, leading to an international recall of the toy beads.

A 2-year-old boy presented to the emergency department (ED) with a decreased level of consciousness. Earlier, he had been playing with his siblings in the backyard. He had been unsteady on his feet an hour before and then became difficult to rouse. There was no history of trauma, ingestion of medicines or plants or intercurrent illness. He had been well previously and was the youngest of 10 siblings.

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  • Naren Gunja1
  • Evelyn Doyle2
  • Kevin Carpenter3
  • Olivia T Chan4
  • Simon Gilmore1
  • Gary Browne2
  • Andis Graudins1

  • 1 NSW Poisons Information Centre, The Children’s Hospital at Westmead, Sydney, NSW.
  • 2 Emergency Department, The Children’s Hospital at Westmead, Sydney, NSW.
  • 3 NSW Biochemical Genetics Service, The Children’s Hospital at Westmead, Sydney, NSW.
  • 4 Department of Medicine, The Children’s Hospital at Westmead, Sydney, NSW.



We would like to thank Dr Maurice Gett (Paediatrician), Dr Holly Smith (Emergency Fellow) and others who looked after the patients.

Competing interests:

None identified.

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