Case report: A 54 years old man under treatment for alcohol related disorders caused a car accident in which two other men died. During autopsy, blood, urine, bile, brain fragments, gastric content and hair (length 3 cm) were collected. Specimens were submitted to toxicological screenings. Ethanol was detected in blood, urine and gastric content. Furthermore, in order to evaluate the frequency and the amount of ethanol assumption, ethyl glucuronide (EtG) was measured in blood, urine and hair. Methods: Screening analyses for amphetamines, triciclic antidepressant, barbiturates, benzodiazepines, cannabinoids, cocaine and opiates were performed by FPIA and EIA, while ethanol was detected by REA. Confirmation results on blood, urine and gastric content were obtained with GC-MS and LC-MS/MS, while ethanol concentration was determined by HS-GC-MS. EtG was detected in blood, urine and hair by LC-MS/MS in ESI (negative ionization) mode. D5-EtG was chosen as the internal standard. Results: Screening analyses turned out positive for antidepressants, benzodiazepines and ethanol. citalopram (antidepressant), delorazepam and lorazepam (benzodiazepines) and ethanol were quantified. Results, including concentrations of EtG, are summarized in table below. Conclusions: The concentration levels found for citalopram, lorazepam and delorazepam were compatible with therapeutic assumption. The high ethanol concentrations found in different biological fluids, indicate that the driver was likely to be under the psychotropic effect of alcohol at the time of the accident. Furthermore, the high concentration of EtG in urine provide evidence of massive alcohol abuse in the hours (up to about 80 h) preceding the accident. Despite the driver was believed to be under treatment for alcohol addiction, the high level of EtG in hair demonstrated its chronic alcohol abuse in the previous months.
The importance of ethyl glucuronide in hair as a biomarker for alcohol abuse
GERACE, ENRICO;A. Salomone;VINCENTI, Marco;
2009-01-01
Abstract
Case report: A 54 years old man under treatment for alcohol related disorders caused a car accident in which two other men died. During autopsy, blood, urine, bile, brain fragments, gastric content and hair (length 3 cm) were collected. Specimens were submitted to toxicological screenings. Ethanol was detected in blood, urine and gastric content. Furthermore, in order to evaluate the frequency and the amount of ethanol assumption, ethyl glucuronide (EtG) was measured in blood, urine and hair. Methods: Screening analyses for amphetamines, triciclic antidepressant, barbiturates, benzodiazepines, cannabinoids, cocaine and opiates were performed by FPIA and EIA, while ethanol was detected by REA. Confirmation results on blood, urine and gastric content were obtained with GC-MS and LC-MS/MS, while ethanol concentration was determined by HS-GC-MS. EtG was detected in blood, urine and hair by LC-MS/MS in ESI (negative ionization) mode. D5-EtG was chosen as the internal standard. Results: Screening analyses turned out positive for antidepressants, benzodiazepines and ethanol. citalopram (antidepressant), delorazepam and lorazepam (benzodiazepines) and ethanol were quantified. Results, including concentrations of EtG, are summarized in table below. Conclusions: The concentration levels found for citalopram, lorazepam and delorazepam were compatible with therapeutic assumption. The high ethanol concentrations found in different biological fluids, indicate that the driver was likely to be under the psychotropic effect of alcohol at the time of the accident. Furthermore, the high concentration of EtG in urine provide evidence of massive alcohol abuse in the hours (up to about 80 h) preceding the accident. Despite the driver was believed to be under treatment for alcohol addiction, the high level of EtG in hair demonstrated its chronic alcohol abuse in the previous months.
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
