Fifty shades of green and blue: autopsy findings after administration of xenobiotics.

IF 1.5 4区 医学 Q2 MEDICINE, LEGAL Forensic Science, Medicine and Pathology Pub Date : 2024-10-30 DOI:10.1007/s12024-024-00903-7
J Baumgarten, I Greb, F Holz, C Nieß, S Petzel-Witt, Christoph G Birngruber
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Abstract

Unusual findings during an autopsy may come from peculiarities in the position, shape, size, weight, consistency, smell or color of organs. The following study was triggered by an autopsy case in which an unusual blue-green discoloration of organs, which changed during the autopsy, was noticed. A review of the local autopsy database, selected cases including the antemortem clinical documentation and the literature has been performed to clarify the etiology of these conspicuous discolorations and to evaluate their diagnostic value. The study showed that certain xenobiotics may lead to such discoloration. After systemic administration of methylene blue, darkening blue-green discoloration of organs, especially the brain and heart, can be observed. In addition, the systemic administration of toluidine blue also appears to be capable of causing such discoloration. Beyond that, drugs (like Rohypnol®) or other foreign substances (like detergents) containing warning colors, i.e. indigocarmin (E132) or Brilliant Blue FCF (E133) may cause discolorations of the upper gastrointestinal tract or the urinary bladder respectively. A blue-green, possibly darkening discoloration of organs during autopsy may point towards an antemortem administration of certain xenobiotics. The affected organs give an indication of the possible route of application and the type of substance. A differentiated interpretation of the etiology of such conspicuous discolorations at autopsy should only be made considering the (medical) history and, if necessary, complementary (toxicological) examinations.

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五十度的绿色和蓝色:服用异种生物制剂后的尸检结果。
尸体解剖中的异常发现可能来自器官的位置、形状、大小、重量、稠度、气味或颜色。下面的研究是由一个尸检病例引发的,在该病例中,人们注意到器官出现了不寻常的蓝绿色褪色,并且在尸检过程中发生了变化。为了弄清这些明显变色的病因并评估其诊断价值,我们对本地尸检数据库、包括尸检临床文件在内的部分病例和文献进行了回顾。研究结果表明,某些异种生物可能会导致这种变色。在全身服用亚甲基蓝后,可观察到器官,特别是大脑和心脏的蓝绿色变暗。此外,全身服用甲苯胺蓝似乎也能导致这种变色。除此之外,含有警示色的药物(如 Rohypnol®)或其他外来物质(如洗涤剂),如靛蓝(E132)或亮蓝 FCF(E133),也可能分别导致上消化道或膀胱变色。在尸检过程中,器官呈现蓝绿色、可能变黑的褪色,可能表明在死前服用了某些异生物制剂。受影响的器官表明了可能的施用途径和物质类型。要对尸体解剖时出现的这种明显变色的病因做出不同的解释,只能考虑(医疗)病史,必要时还应进行补充(毒理学)检查。
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来源期刊
Forensic Science, Medicine and Pathology
Forensic Science, Medicine and Pathology MEDICINE, LEGAL-PATHOLOGY
CiteScore
3.90
自引率
5.60%
发文量
114
审稿时长
6-12 weeks
期刊介绍: Forensic Science, Medicine and Pathology encompasses all aspects of modern day forensics, equally applying to children or adults, either living or the deceased. This includes forensic science, medicine, nursing, and pathology, as well as toxicology, human identification, mass disasters/mass war graves, profiling, imaging, policing, wound assessment, sexual assault, anthropology, archeology, forensic search, entomology, botany, biology, veterinary pathology, and DNA. Forensic Science, Medicine, and Pathology presents a balance of forensic research and reviews from around the world to reflect modern advances through peer-reviewed papers, short communications, meeting proceedings and case reports.
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