Document Detail


Toxicological and histopathological analysis of a patient who died nine days after a single intravenous dose of methamphetamine: a case report.
MedLine Citation:
PMID:  16793314     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A man in his late twenties collapsed shortly after intravenously injecting himself with methamphetamine (MA). He slipped into a deep coma and remained in this condition for 9 days, until his death. Autopsy revealed severe brain edema and localized subarachnoid hemorrhages in the cerebrum and cerebellum. Histopathological examination revealed myocardial necrosis in the left ventricle, rhabdomyolysis and bronchopneumonia. Blood derived from the cadaver was found to have high levels of blood urea nitrogen and creatinine, suggesting he experienced acute renal failure probably due to rhabdomyolysis. Most of the postmortem findings were consistent with MA poisoning. The patient's bronchopneumonia may have represented a hypostatic pneumonia that developed as a result of his deep coma. While the patient's brain edema, myocardial necrosis and rhabdomyolysis were diagnosed soon after admission, his bronchopneumonia and acute renal failure only occurred 6 and 8 days later, respectively. Although MA was not detected in the cadaver's blood, urine or liver, analysis of the decedent's hair using gas chromatography-mass spectrometry confirmed its presence at a concentration of 1.1 ng/mg. Based on these findings, we concluded that the patient's cause of death was multiorganopathy resulting from MA poisoning. This case suggests that the postmortem diagnosis of MA poisoning in patients who survive for relatively longer periods after drug injection should include toxicological hair analysis in combination with histopathological and postmortem physiochemical examination.
Authors:
Mihoko Ago; Kazutoshi Ago; Kenji Hara; Seiichi Kashimura; Mamoru Ogata
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2006-06-21
Journal Detail:
Title:  Legal medicine (Tokyo, Japan)     Volume:  8     ISSN:  1344-6223     ISO Abbreviation:  Leg Med (Tokyo)     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-07-31     Completed Date:  2006-12-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100889186     Medline TA:  Leg Med (Tokyo)     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  235-9     Citation Subset:  IM    
Affiliation:
Department of Legal Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8544, Japan. agomiho@m.kufm.kagoshima-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Urea Nitrogen
Brain Edema / pathology
Bronchopneumonia / pathology
Central Nervous System Stimulants / administration & dosage,  analysis,  poisoning*
Coma / chemically induced*
Creatinine / blood
Forensic Pathology
Forensic Toxicology
Gas Chromatography-Mass Spectrometry
Hair / chemistry
Humans
Injections, Intravenous
Male
Methamphetamine / administration & dosage,  analysis,  poisoning*
Myocardium / pathology
Necrosis / pathology
Poisoning / diagnosis
Rhabdomyolysis / pathology
Subarachnoid Hemorrhage / pathology
Chemical
Reg. No./Substance:
0/Central Nervous System Stimulants; 537-46-2/Methamphetamine; 60-27-5/Creatinine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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