一个不寻常的病例致命低温涉及局部苯海拉明。

IF 2.8 4区 医学 Q2 TOXICOLOGY Forensic Toxicology Pub Date : 2023-01-01 DOI:10.1007/s11419-022-00637-7
Maiko Kusano, Masaya Fujishiro, Mari Hashimoto, Ming Jui Ng, Ryuji Yoshida, Shin-Ichiro Narita, Akihiro Nakauchi, Keizo Sato, Yuichiro Tachi, Taka-Aki Matsuyama
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引用次数: 2

摘要

目的:苯海拉明是一种抗组胺药,广泛用于缓解过敏和普通感冒引起的症状。过去曾有与苯海拉明有关的死亡报告,但通常是由于摄入过量。我们报告一个特殊的情况下,致命的体温过低在非冬季涉及局部苯海拉明。方法:发现一名23岁男性死于其公寓浴室,其背部有少量自来水。进行了尸检和血液、尿液毒理学分析。结果:左、右心血色差明显。胃粘膜可见维什纽斯基斑。组织学检查未见明显的严重心血管事件。采用气相色谱-串联质谱法(GC/MS/MS)对血液和尿液中的苯海拉明进行药物筛选。进一步的定量显示,死后血中浓度为0.44 μg/mL,尿中浓度为2500 μg/mL。结论:死亡原因确定为体温过低。苯海拉明引起的嗜睡和可能的内在心脏因素可能导致长期意识受损,使他无法从流动的冷水中逃脱,从而导致体温过低和死亡。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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An unusual case of fatal hypothermia involving topical diphenhydramine.

Purpose: Diphenhydramine is an antihistamine drug widely used to alleviate symptoms caused by allergies and the common cold. Diphenhydramine-involved fatalities have been reported in the past but usually involving overdose by ingestion. We report a peculiar case of fatal hypothermia during non-winter season involving topical diphenhydramine.

Methods: A 23-year-old male with no known preexisting medical conditions was found dead in the bathroom of his apartment with a small amount of running water on his back. Postmortem examinations and toxicological analysis on blood and urine were performed.

Results: Color difference was apparent between the right and left cardiac blood. Wischnewski spots were observed in the gastric mucosa. Histological examination revealed no obvious findings that could attribute to serious cardiovascular events. Drug screening by gas chromatograph-tandem mass spectrometry (GC/MS/MS) detected diphenhydramine in blood and urine. Further quantification revealed the postmortem concentrations to be 0.44 μg/mL in blood and 2500 μg/mL in urine.

Conclusions: The cause of death was determined to be hypothermia. Diphenhydramine-induced drowsiness and possible intrinsic cardiac factor may have led to prolonged impaired consciousness, preventing his ability to escape from the running cold water leading to hypothermia and death.

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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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