Mishima-Kimura Satoko, Yonemitsu Kosei, Ohtsu Yuki, Sasao Ako, Tsutsumi Hiroshi, Furukawa Shota, Nishitani Yoko
Department of Forensic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
Department of Forensic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
Leg Med (Tokyo). 2018 May;32:48-51. doi: 10.1016/j.legalmed.2018.02.006. Epub 2018 Mar 2.
We report a forensic autopsy case of an elderly man who ingested unknown amount of germicidal disinfectant containing 50% benzalkonium chloride (BZK). He survived for 18 days after BZK ingestion and then died because of pneumonia. A liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was used to detect three BZK compounds (C-BZK, C-BZK and C-BZK) in the blood. Extraction of BZK was carried out according to a modified QuEChERS method. Chromatographic separation was achieved on an ODS column and detection was performed in selected reaction monitoring mode. The accuracy and the precision were acceptable for quantitative analysis in the concentration range of 10-200 ng/mL for the three BZK compounds. BZK was detected in heart and femoral vein blood samples even 18 days after BZK ingestion. Taking into consideration clinical information during 18 days hospitalization and the autopsy findings, the cause of death was attributed to BZK poisoning. Several toxico-kinetic factors regarding absorption and excretion of BZK in the body were also discussed to elucidate the detection of BZK such a long time after ingestion.
我们报告了一例老年男性的法医尸检案例，该男子摄入了未知量的含50%苯扎氯铵（BZK）的杀菌消毒剂。他在摄入BZK后存活了18天，随后因肺炎死亡。采用液相色谱 - 串联质谱（LC-MS/MS）法检测血液中的三种BZK化合物（C-BZK、C-BZK和C-BZK）。BZK的提取按照改良的QuEChERS方法进行。在ODS柱上实现色谱分离，并在选择反应监测模式下进行检测。三种BZK化合物在10 - 200 ng/mL浓度范围内进行定量分析时，准确度和精密度均可接受。即使在摄入BZK 18天后，在心脏和股静脉血样中仍检测到BZK。考虑到18天住院期间的临床信息和尸检结果，死亡原因归因于BZK中毒。还讨论了关于BZK在体内吸收和排泄的几个毒代动力学因素，以阐明摄入后如此长时间仍能检测到BZK的原因。
