Comparison of postmortem butane distribution between two fatal butane poisoning cases

Shintani-Ishida, Kaori; Tsuboi, Hajime; Ichioka, Hiroaki; Ikegaya, Hiroshi

doi:10.1016/j.legalmed.2018.09.008

Cited by 8 publications

(6 citation statements)

References 17 publications

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“…Two patients inhaled liquefied petroleum gas, a propane/butane gas mixture. To facilitate reading, data are summarized in Table 1 for survivors 8,13–22 and Table 2 for fatalities 1–4,14,15,18,20,23–43 . Patients were predominantly males (81%) aged between 11 and 70 years (mean age ± SD, 23 ± 13 years).…”

Section: Resultsmentioning

confidence: 99%

A two‐decade review of butane toxicity as a substance of abuse

Vahabzadeh

Mégarbane

2022

Basic Clin Pharma Tox

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Butane, an aliphatic hydrocarbon with explosive and flammable properties, is widely misused especially by young people. Acting as an asphyxiant gas, butane mainly targets the central nervous and cardiovascular systems. We aimed to review butane‐attributed toxicities due to its harmful use or misuse reported in a two‐decade period. We searched English‐language publications reporting butane toxicities from 2000 up to 2021 and collected data on age, gender, route and source of exposure, country of origin, clinical presentation and outcome. Among 54 butane's harmful use/misuse cases identified in the literature, there were 11 survivors successfully discharged from the hospital. Patients were predominantly males with a mean age ± SD of 23 ± 13 years. The main route of exposure was inhalation. Manifestations were mainly cardiac and neurological. Majority of the cases were reported from Europe and Japan. To conclude, butane exposure is at risk of severe central nervous system and cardiac toxicities, which may result in a fatal outcome. Therefore, in the event of a sudden or suspicious death in a young individual, our findings suggest that butane's harmful use/misuse should be considered as a potential differential diagnosis.

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Section: Resultsmentioning

confidence: 99%

A two‐decade review of butane toxicity as a substance of abuse

Vahabzadeh

Mégarbane

2022

Basic Clin Pharma Tox

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“…Some analytes may be lost during collection and storage, and this can lead to incorrect quantitation and false negative results (21). In cases of suspected butane intoxication, fat and brain tissue samples, where butane remains for long periods, can be analyzed as alternatives to blood samples (12,14). Fat and brain tissue samples reflect chronic use of volatile substances.…”

Section: Discussionmentioning

confidence: 99%

“…Most forensic publications recommend immediate taking of samples in suspected cases of butane intoxication and sample storage in appropriate closed glass jars, followed by analysis in as short a time as possible after collection (4)(5)(6)(7)(8). Despite the rapid clearance of inhaled butane, it tends to remain in brain and fat tissues because of high liposolubility (12,13). Sironi et al investigated the distribution of butane and propane in two cases of fatal butane intoxication and showed that a high concentration in fat (adipose) tissue was consistent with the time interval from gas inhalation to death (12,14).…”

Section: Introductionmentioning

confidence: 99%

“…Despite the rapid clearance of inhaled butane, it tends to remain in brain and fat tissues because of high liposolubility (12,13). Sironi et al investigated the distribution of butane and propane in two cases of fatal butane intoxication and showed that a high concentration in fat (adipose) tissue was consistent with the time interval from gas inhalation to death (12,14).…”

Section: Introductionmentioning

confidence: 99%

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A Case Series of Butane Intoxication Fatalities in the Southeastern Anatolia Region of Türkiye

DÜNDAR,

ALTIN

2023

Medical Records

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Aim: Volatile solvent abuse (VSA), is the third most common form of substance abuse after alcohol and cigarettes. The aim of this study was to determine the incidence of fatalities due to butane gas. Material and Methods: From 8,075 autopsies conducted in our center in Şanlıurfa, Türkiye in a 10-year period, 10 deaths were determined to be due to butane gas intoxication. Results: All the fatalities were males (mean age: 17.6 years). Friends reported chronic use of lighter gas by the fatalities prior to the incident. In contrast, close relatives stated that it was the first instance of VSA. The preferred inhalation methods were bagging (i.e., inhaling gas from a plastic bag, n=4) and direct inhalation (i.e., spraying the gas directly in the mouth, n=6). The scene of incident findings revealed more than one lighter gas cartridge at the scene in nine cases and many lighters at the scene in one case. The autopsy examinations revealed minimal grazing on the body in three cases and no traumatic findings in seven cases. Butane was detected in blood samples in all 10 cases and in lung tissue samples in eight cases. In all 10 cases, there were areas of intra-alveolar swelling, edema, and bleeding in the lungs. Conclusion: The actual incidence of VSA-related deaths is likely much higher than the number of reported cases, as our center is located near the Syrian border and has one of the highest populations of children and young people in Türkiye.

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“…Assessing analytical findings in tissues known for long-term persistence of substances concerning that issue might be helpful. Although a precise determination of the time of consumption is not possible, adipose tissue (AT) proved to be an alternative specimen for detecting drugs, pharmaceuticals, and pollutants, especially lipophilic ones, in PM toxicology (Colucci et al 2010 ; De Saeger et al 2005 ; Hikiji et al 2010 ; Mühlebach et al 1985 ; Shintani-Ishida et al 2018 ). Contrary to blood, AT is available in higher amounts, even if a decedent is already putrefied.…”

Section: Introductionmentioning

confidence: 99%

Is adipose tissue suitable for detection of (synthetic) cannabinoids? A comparative study analyzing antemortem and postmortem specimens following pulmonary administration of JWH-210, RCS-4, as well as ∆9-tetrahydrocannabinol to pigs

et al. 2020

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Examining fatal poisonings, chronic exposure may be reflected by the concentration in tissues known for long-term storage of drugs. Δ9-tetrahydrocannabinol (THC) persists in adipose tissue (AT), but sparse data on synthetic cannabinoids (SC) are available. Thus, a controlled pig study evaluating antemortem (AM) disposition and postmortem (PM) concentration changes of the SC 4-ethylnaphthalene-1-yl-(1-pentylindole-3-yl)methanone (JWH-210) and 2-(4-methoxyphenyl)-1-(1-pentyl-indole-3-yl)methanone (RCS-4) as well as THC in AT was performed. The drugs were administered pulmonarily (200 µg/kg body weight) to twelve pigs. Subcutaneous (s.c.) AT specimens were collected after 15 and 30 min and then hourly up to 8 h. At the end, pigs were sacrificed and s.c., perirenal, and dorsal AT specimens were collected. The carcasses were stored at room temperature (RT; n = 6) or 4 °C (n = 6) and specimens were collected after 24, 48, and 72 h. After homogenization in acetonitrile and standard addition, LC–MS/MS was performed. Maximum concentrations were reached 0.5–2 h after administration amounting to 21 ± 13 ng/g (JWH-210), 24 ± 13 ng/g (RCS-4), and 22 ± 20 ng/g (THC) and stayed at a plateau level. Regarding the metabolites, very low concentrations of N-hydroxypentyl-RCS-4 (HO-RCS-4) were detected from 0.5 to 8 h. PM concentrations of parent compounds did not change significantly (p > 0.05) over time under both storage conditions. Concentrations of HO-RCS-4 significantly (p < 0.05) increased in perirenal AT during storage at RT. These results suggest a rapid distribution and persistence in s.c. AT. Furthermore, AT might be resistant to PM redistribution of parent compounds. However, significant PM increases of metabolite concentrations might be considered in perirenal AT.

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Comparison of postmortem butane distribution between two fatal butane poisoning cases

Cited by 8 publications

References 17 publications

A two‐decade review of butane toxicity as a substance of abuse

A two‐decade review of butane toxicity as a substance of abuse

A Case Series of Butane Intoxication Fatalities in the Southeastern Anatolia Region of Türkiye

Is adipose tissue suitable for detection of (synthetic) cannabinoids? A comparative study analyzing antemortem and postmortem specimens following pulmonary administration of JWH-210, RCS-4, as well as ∆9-tetrahydrocannabinol to pigs

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