Jamey Carole, Kintz Pascal, Martrille Laurent, Raul Jean-Sébastien
Laboratoire de Toxicologie, Institut de Médecine légale, 11 rue Humann, 67000 Strasbourg, France
Laboratoire de Toxicologie, Institut de Médecine légale, 11 rue Humann, 67000 Strasbourg, France.
J Anal Toxicol. 2016 Sep;40(7):546-52. doi: 10.1093/jat/bkw058. Epub 2016 Jul 11.
We reported the case of 69-year-old man who was discovered dead at a friend's home. 3-Methylmethcathinone (3-MMC) and poppers (alkyl nitrites) were found at the scene by the police. Autopsy specimens including peripheral and cardiac blood, urine, gastric content, bile and hair were sent to our laboratory to document a possible death involving abuse of drugs. Routine toxicological analysis was performed with gas chromatography with flame ionization detection (GC-FID), high performance liquid chromatography-diode array detection (HPLC-DAD), headspace gas chromatography-mass spectrometry (HS-GC-MS), gas chromatography-mass spectrometry (GC-MS) and liquid chromatography-mass spectrometry (LC-MS)-MS. After liquid-liquid extraction at alkaline pH, 3-MMC was identified with GC-MS (to allow the discrimination with 4-MMC) and quantified with ultra-performance liquid chromatography-mass spectrometry (UPLC-MS)-MS with the two following transitions: m/z 178.1 > 160 and 178.1 > 144.9. Gamma-hydroxybutyric acid (GHB) was analyzed by GC-MS for fluids and GC-MS-MS for hair. Toxicological analysis in peripheral blood revealed the presence of 3-MMC (0.33 mg/L), pseudoephedrine (0.03 mg/L) and GHB (576 mg/L). These molecules have also been found in other post-mortem fluids. Furthermore, testing for "poppers" by HS-GC-MS was negative. Hair analysis, without segmentation, demonstrated the presence of 3-MMC (206.7 ng/mg), pseudoephedrine (0.16 ng/mg) and GHB (96.3 ng/mg) and suggested a repeated consumption of these substances. However, one cannot exclude contamination by sweat during the agony period. Toxicological post-mortem results suggest a fatal combination of 3-MMC and GHB. Despite his age, the decedent was known to abuse drugs.
我们报告了一名69岁男子的案例，他被发现死于朋友家中。警方在现场发现了3-甲基甲卡西酮（3-MMC）和Poppers（亚硝酸烷基酯）。包括外周血和心脏血、尿液、胃内容物、胆汁和毛发在内的尸检样本被送往我们实验室，以证明可能存在涉及药物滥用的死亡情况。采用气相色谱-火焰离子化检测（GC-FID）、高效液相色谱-二极管阵列检测（HPLC-DAD）、顶空气相色谱-质谱联用（HS-GC-MS）、气相色谱-质谱联用（GC-MS）和液相色谱-质谱联用（LC-MS）-MS进行常规毒理学分析。在碱性pH值下进行液-液萃取后，用GC-MS鉴定3-MMC（以便与4-MMC区分），并用超高效液相色谱-质谱联用（UPLC-MS）-MS对其进行定量，有以下两个跃迁：m/z 178.1 > 160和178.1 > 144.9。γ-羟基丁酸（GHB）通过GC-MS分析液体样本，通过GC-MS-MS分析毛发样本。外周血毒理学分析显示存在3-MMC（0.33 mg/L）、伪麻黄碱（0.03 mg/L）和GHB（576 mg/L）。这些分子也在其他尸检体液中被发现。此外，通过HS-GC-MS检测“Poppers”呈阴性。未进行分段的毛发分析显示存在3-MMC（206.7 ng/mg）、伪麻黄碱（0.16 ng/mg）和GHB（96.3 ng/mg），表明这些物质被反复使用。然而，不能排除临死期间汗液造成的污染。尸检毒理学结果表明3-MMC和GHB的致命组合。尽管死者年事已高，但已知其有药物滥用史。
