此处报道了1,4-丁二醇(1,4-BD)口服摄入的致命病例,一名51岁的男子被发现死在床上。根据警方的报告,死者是一名已知的吸毒者。在厨房中发现了一个标有(后来确认为)“丁二醇1,4”(1,4-BD)的玻璃瓶。此外,死者的朋友说他经常食用1,4-BD。尸检和尸体解剖器官标本的组织学检查未发现明确的死亡原因。化学毒理学研究显示,体液和组织中的γ-羟基丁酸(GHB)含量如下:股骨血液390mg/L,心脏血液420毫克/升,脑脊液420mg/L,玻璃体液640mg/L,尿液1600毫克/升,和头发26.7ng/mg。此外,在头发中定性检测到1,4-BD,尿液,胃内容物,还有瓶子。没有其他物质,包括酒精,在药理学相关浓度下检测到。已知1,4-BD是体内转化为GHB的前体物质。在毒理学结果的天气评估中,警方调查并排除其他死因,摄入1,4-BD后致命的GHB中毒,在这种情况下可以假设。1,4-BD的致命中毒很少被报道,由于转化为GHB的速度非常快,除其他外,摄入后的非特异性症状。本病例报告旨在概述已发表的致命1,4-BD中毒,并讨论与在(死后)标本中检测1,4-BD相关的问题。
A fatal
case of 1,4-butanediol (1,4-BD) oral ingestion is reported here, in which a 51-year-old man was found dead in his bed. According to the police report, the deceased was a known drug user. A glass bottle labeled (and later confirmed to be) \"Butandiol 1,4\" (1,4-BD) was found in the kitchen. Furthermore, the deceased\'s friend stated that he consumed 1,4-BD on a regular basis. The autopsy and histological examination of postmortem parenchymatous organ specimens did not revealed a clear cause of death. Chemical-toxicological investigations revealed gammahydroxybutyrat (GHB) in body fluids and tissues in the following quantities: femoral blood 390 mg/L, heart blood 420 mg/L, cerebrospinal fluid 420 mg/L, vitreous humor 640 mg/L, urine 1600 mg/L, and head hair 26.7 ng/mg. In addition, 1,4-BD was qualitatively detected in the head hair, urine, stomach contents, and the bottle. No other substances, including alcohol, were detected at pharmacologically relevant concentrations. 1,4-BD is known as precursor substance that is converted in vivo into GHB. In the synoptic assessment of toxicological findings, the police investigations and having excluded other causes of death, a lethal GHB-intoxication following ingestion of 1,4-BD, can be assumed in this
case. Fatal intoxications with 1,4-BD have seldom been reported due to a very rapid conversion to GHB and, among other things, non-specific symptoms after ingestion. This
case report aims to give an overview to the published of fatal 1,4-BD-intoxications and to discuss the problems associated with detection of 1,4-BD in (postmortem) specimens.