PMID- 15062945
OWN - NLM
STAT- MEDLINE
DCOM- 20040622
LR  - 20131121
IS  - 0379-0738 (Print)
IS  - 0379-0738 (Linking)
VI  - 141
IP  - 2-3
DP  - 2004 May 10
TI  - Interpretation of a 3,4-methylenedioxymethamphetamine (MDMA) blood level: 
      discussion by means of a distribution study in two fatalities.
PG  - 85-90
AB  - The amphetamine derivative 3,4-methylenedioxymethamphetamine (MDMA, "Ecstasy" is 
      a currently used or abused designer drug and fatalities are frequently 
      encountered in forensic practice. However, the question remains open whether an 
      MDMA blood level can be toxic or even potentially lethal. In order to provide 
      insight in the interpretation of a detected MDMA concentration, the distribution 
      of MDMA and its metabolite 3,4-methylenedioxyamphetamine (MDA) in various body 
      fluids and tissues was studied and discussed in two different fatalities. Apart 
      from peripheral blood samples (such as femoral and subclavian blood), various 
      blood samples obtained centrally in the human body and several body fluids (such 
      as vitreous humour) were examined. In addition, various tissues such as cardiac 
      muscle, lungs, liver, kidneys, and brain lobes were analysed. In contrast to the 
      peripheral blood levels, high MDMA and MDA levels were found in cardiac blood and 
      the majority of the organs, except for the abdominal adipose tissue. The high 
      concentrations observed in all lung lobes, the liver and stomach contents 
      indicate that post-mortem redistribution of MDMA and MDA into cardiac blood can 
      occur and, as a result, blood sampled centrally in the body should be avoided. 
      Therefore, our data confirm that peripheral blood sampling remains "the golden 
      standard". In addition, a distinct difference in peripheral blood MDMA 
      concentrations in our two overdose cases was established (namely 0.271 and 13.508 
      microg/ml, respectively). Furthermore, our results suggest that, if a peripheral 
      blood sample is not available and when putrefaction is not too pronounced, 
      vitreous humour and iliopsoas muscle can be valuable specimens for toxicological 
      analysis. Finally, referring to the various mechanisms of death following 
      amphetamine intake, which can result in different survival times (e.g. 
      cardiopulmonary complications versus hyperthermia), the anatomo-pathological 
      findings and the toxicological results should be considered as a whole in 
      arriving at a conclusion.
FAU - De Letter, Els A
AU  - De Letter EA
AD  - Department of Forensic Medicine, Ghent University, Jozef Kluyskensstraat 29, 9000 
      Gent, Belgium.
FAU - Bouche, Marie-Paule L A
AU  - Bouche MP
FAU - Van Bocxlaer, Jan F
AU  - Van Bocxlaer JF
FAU - Lambert, Willy E
AU  - Lambert WE
FAU - Piette, Michel H A
AU  - Piette MH
LA  - eng
PT  - Journal Article
PL  - Ireland
TA  - Forensic Sci Int
JT  - Forensic science international
JID - 7902034
RN  - 0 (Hallucinogens)
RN  - 4764-17-4 (3,4-Methylenedioxyamphetamine)
RN  - KE1SEN21RM (N-Methyl-3,4-methylenedioxyamphetamine)
SB  - IM
MH  - 3,4-Methylenedioxyamphetamine/analysis/*pharmacokinetics/poisoning
MH  - Adolescent
MH  - Adult
MH  - Bile/chemistry
MH  - Chromatography, High Pressure Liquid
MH  - Drug Overdose
MH  - Forensic Medicine/methods
MH  - Hallucinogens/analysis/*pharmacokinetics/poisoning
MH  - Humans
MH  - Kidney/chemistry
MH  - Liver/chemistry
MH  - Lung/chemistry
MH  - Male
MH  - Myocardium/chemistry
MH  - N-Methyl-3,4-methylenedioxyamphetamine/analysis/*pharmacokinetics/poisoning
MH  - Pituitary Gland/chemistry
MH  - *Postmortem Changes
MH  - Psoas Muscles/chemistry
MH  - Stomach/chemistry
MH  - Tissue Distribution
MH  - Vitreous Body/chemistry
EDAT- 2004/04/06 05:00
MHDA- 2004/06/24 05:00
CRDT- 2004/04/06 05:00
PHST- 2003/07/24 00:00 [received]
PHST- 2003/12/12 00:00 [accepted]
PHST- 2004/04/06 05:00 [pubmed]
PHST- 2004/06/24 05:00 [medline]
PHST- 2004/04/06 05:00 [entrez]
AID - S0379073804000040 [pii]
AID - 10.1016/j.forsciint.2003.12.015 [doi]
PST - ppublish
SO  - Forensic Sci Int. 2004 May 10;141(2-3):85-90. doi: 
      10.1016/j.forsciint.2003.12.015.