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Forensic Toxicology

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17.05.2022 | Case Report

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

verfasst von: Benedicte Lelievre, Vincent Dupont, Celine Buchaillet, Nathalie Jousset, Marie Deguigne, Vincent Cirimele

Erschienen in: Forensic Toxicology | Ausgabe 2/2022

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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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Titel: Difficulties interpreting concentrations in fatal cases: example of 2,5-dimethoxy-4-chloroamphetamine
verfasst von: Benedicte Lelievre
Vincent Dupont
Celine Buchaillet
Nathalie Jousset
Marie Deguigne
Vincent Cirimele
Publikationsdatum: 17.05.2022
Verlag: Springer Nature Singapore
Erschienen in: Forensic Toxicology / Ausgabe 2/2022
Print ISSN: 1860-8965
Elektronische ISSN: 1860-8973
DOI: https://doi.org/10.1007/s11419-022-00628-8

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

Abstract

Purpose

Methods

Results

Conclusion

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Conclusion

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