Difficulties interpreting concentrations in fatal cases: example of 2,5-dimethoxy-4-chloroamphetamine.

IF 2.8 4区 医学 Q2 TOXICOLOGY Forensic Toxicology Pub Date : 2022-07-01 DOI:10.1007/s11419-022-00628-8
Benedicte Lelievre, Vincent Dupont, Celine Buchaillet, Nathalie Jousset, Marie Deguigne, Vincent Cirimele
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引用次数: 1

Abstract

Purpose: Death related to the use of drugs is evident when drugs are detected in biological matrices within toxic levels, but sometimes it can be less obvious. Intoxications after 2,5-dimethoxy-4-chloroamphetamine (DOC) use are occurring but up to date, only one fatality has been reported. Here we present the case of a young woman admitted to hospital as she presented vomiting, convulsions and cardiorespiratory arrest.

Methods: Blood ethanol concentration was determined using gas chromatography with flame ionization detection and toxicological screenings (blood, gastric content and hair samples) were performed using liquid chromatography with diode array detection, gas chromatography or liquid chromatography with mass spectrometry detection.

Results: Her health state declined with cardiac troubles, organs failure and cerebral edema till death occurring 4 days later. The autopsy revealed the presence of hemorrhagic infiltration inside the left ventricle, pulmonary edema and hemorrhagic infiltration of the terminal ileum. The analysis of biological fluids confirmed the presence of DOC (< 10 ng/mL in cardiac blood sample), buprenorphine, cocaine and cannabis metabolites. The analysis of hair highlighted a history of drugs abuse.

Conclusion: In the absence of evident identified cause, the hypothesis of a death due to acute drugs use within a history of chronic consumption of drugs has been put forward. The concentration of some substances such as new psychoactive substances can be low in biological matrices but the toxic effects can be additive and lead to death even within young people, hence the importance of the knowledge of consumption history.

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在致命病例中解释浓度的困难:例如2,5-二甲氧基-4-氯安非他明。
目的:当在生物基质中检测到药物处于毒性水平时,与药物使用有关的死亡是明显的,但有时可能不那么明显。使用2,5-二甲氧基-4-氯安非他明(DOC)后出现中毒,但迄今为止,仅报告了一例死亡。在这里,我们提出的情况下,一名年轻女子入院,因为她的呕吐,抽搐和心肺骤停。方法:采用气相色谱法结合火焰电离检测法测定血液乙醇浓度,采用液相色谱法结合二极管阵列检测法、气相色谱法或液相色谱法结合质谱法对血液、胃内容物和毛发样本进行毒理学筛选。结果:患者健康状况下降,出现心脏疾病、脏器衰竭、脑水肿,4 d后死亡。尸检显示左心室内有出血浸润,肺水肿,回肠末端有出血浸润。生物体液分析证实了DOC的存在(结论:在没有明确病因的情况下,提出了慢性用药史中急性用药死亡的假设。某些物质,如新型精神活性物质,在生物基质中的浓度可能很低,但毒性作用可能是累加性的,甚至在年轻人中也会导致死亡,因此了解消费历史非常重要。
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来源期刊
Forensic Toxicology
Forensic Toxicology TOXICOLOGY-
CiteScore
5.80
自引率
9.10%
发文量
40
审稿时长
3 months
期刊介绍: The journal Forensic Toxicology provides an international forum for publication of studies on toxic substances, drugs of abuse, doping agents, chemical warfare agents, and their metabolisms and analyses, which are related to laws and ethics. It includes original articles, reviews, mini-reviews, short communications, and case reports. Although a major focus of the journal is on the development or improvement of analytical methods for the above-mentioned chemicals in human matrices, appropriate studies with animal experiments are also published. Forensic Toxicology is the official publication of the Japanese Association of Forensic Toxicology (JAFT) and is the continuation of the Japanese Journal of Forensic Toxicology (ISSN 0915-9606).
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