Yamamoto Hiroki, Takayasu Tatsunori, Nosaka Mizuho, Kimura Akihiko, Ishida Yuko, Kawaguchi Takashi, Fukami Mie, Okada Misato, Kondo Toshikazu
Department of Forensic Medicine, Wakayama Medical University, Wakayama, Japan.
Forensic Toxicology Unit, Department of Forensic Medicine and Pathology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
Leg Med (Tokyo). 2017 Jan;24:12-18. doi: 10.1016/j.legalmed.2016.11.002. Epub 2016 Nov 5.
A fatal case of acute nifedipine intoxication in a two-year-old boy is presented. The boy accidentally orally ingested an unknown amount of his grandfather's nifedipine (40mg/tablet), mistaking it for a ramune confectionery. Despite intensive medical treatment, his death was confirmed at 31h after the accidental ingestion. The forensic autopsy revealed that there were neither pathological alterations or injuries in all of the organs. Toxicologically, nifedipine could be detected at the concentrations of 0.463, 0.669 and 13.0μg/g in cardiac blood, peripheral blood and stomach contents, respectively. These concentrations were evaluated as fatal levels, and the cause of death was diagnosed as acute nifedipine intoxication. Recently, the number of infants and children who accidentally ingest drugs in the home is increasing. This case report prompts forensic pathologists and toxicologists to emphasize that children are always exposed to the risk of accidental drug ingestion in daily life.
本文报告了一名两岁男童急性硝苯地平中毒致死的病例。该男童误将祖父的硝苯地平(每片40毫克)当作弹珠汽水糖果意外口服,具体摄入量不明。尽管接受了积极的治疗,但在误服后31小时仍被确认死亡。法医尸检显示,所有器官均未发现病理改变或损伤。毒理学检测发现,心脏血液、外周血和胃内容物中硝苯地平的浓度分别为0.463、0.669和13.0微克/克。这些浓度被评估为致死水平,死亡原因被诊断为急性硝苯地平中毒。近年来,家中婴幼儿意外服药的数量呈上升趋势。本病例报告促使法医病理学家和毒理学家强调,儿童在日常生活中始终面临意外服药的风险。