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A fatal methamphetamine poisoning associated with hyperpyrexia
Abstract:
After self-administration of 0.05 g of methamphetamine hydrochloride intravenously on three occasions at intervals of 3 h, a 25-year-old female methamphetamine abuser ingested approximately 1.5 g of methamphetamine hydrochloride, and was found dead 3-4 h later. Complete rigor mortis was observed 1-2 h after death and the rectal temperature was 38.4 degrees C 3-4 h after death. Distribution of methamphetamine and amphetamine in the body was analyzed by chemical ionization mass fragmentography. Amphetamine/methamphetamine concentrations (mumol/100 g) were 0.26/28.8 in blood, 0.64/68.2 in brain, 0.96/117.1 in liver, 0.53/50.6 in kidney, and 1.49/1045 in stomach contents. Total amount of methamphetamine hydrochloride in stomach contents was 11.6 mg. Amphetamine in tissues was a metabolite of methamphetamine, and amphetamine in stomach contents resulted from excretion into saliva and gastric mucous excretion. With rectal temperature at death estimated at more than 41 degrees C, it would seem that hyperpyrexia played an important role in causing death from methamphetamine poisoning.
Insights
A fatal methamphetamine overdose case highlights hyperpyrexia as a potential cause of death. High concentrations of methamphetamine and its metabolite, amphetamine, were found in tissues, indicating severe poisoning.
Area of Science:
- Forensic Toxicology
- Pharmacology
Background:
- Methamphetamine abuse is a significant public health concern.
- Understanding the toxicokinetics and lethal mechanisms of methamphetamine is crucial for forensic investigations.
Observation:
- A 25-year-old female methamphetamine abuser died after ingesting a large dose (approximately 1.5 g) of methamphetamine hydrochloride intravenously.
- Rigor mortis onset was rapid (1-2 hours post-mortem).
- Rectal temperature 3-4 hours post-mortem was 38.4°C, with an estimated post-mortem core temperature exceeding 41°C at the time of death.
Findings:
- Chemical ionization mass fragmentography revealed high concentrations of methamphetamine and its metabolite, amphetamine, in various tissues.
- Concentrations (μmol/100 g) included: blood (0.26/28.8), brain (0.64/68.2), liver (0.96/117.1), kidney (0.53/50.6), and stomach contents (1.49/1045).
- Significant amounts of methamphetamine hydrochloride (11.6 mg) were present in stomach contents.
Implications:
- Hyperpyrexia (elevated body temperature) is suggested as a primary factor contributing to the fatality.
- The distribution of methamphetamine and amphetamine provides insights into the drug's metabolism and systemic effects.
- This case underscores the extreme toxicity of methamphetamine and the potential for rapid, fatal outcomes.