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

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 pr...

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Bibliographic Details
Published in:Forensic toxicology 2022-07, Vol.40 (2), p.383-392
Main Authors: Lelievre, Benedicte, Dupont, Vincent, Buchaillet, Celine, Jousset, Nathalie, Deguigne, Marie, Cirimele, Vincent
Format: Article
Language:English
Subjects:
Adolescent
Amphetamine
Brain Death
Case Report
Chromatography, Liquid
Female
Flame Ionization
Forensic Medicine
Forensic Science
Gas Chromatography-Mass Spectrometry
Humans
Life Sciences
Medical Law
Medicinal Chemistry
Medicine
Medicine & Public Health
Pharmacology/Toxicology
Toxicology
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Summary: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 (
ISSN:1860-8965
1860-8973
DOI:10.1007/s11419-022-00628-8