PMID- 18714853
OWN - NLM
STAT- MEDLINE
DCOM- 20080923
LR  - 20160307
IS  - 1784-3286 (Print)
IS  - 1784-3286 (Linking)
VI  - 63
IP  - 3
DP  - 2008 May-Jun
TI  - Gamma-hydroxybutyric acid (GHB) measurement by GC-MS in blood, urine and gastric 
      contents, following an acute intoxication in Belgium.
PG  - 200-8
AB  - Gamma-hydroxybutyrate (GHB, sodium oxybate) is a compound related to 
      neuromodulator gamma-aminobutyric acid (GABA), emerging as a recreational drug of 
      abuse and as a rape drug. GHB-related emergencies have dramatically increased in 
      the 1990s, but a decrease is observed since 2000. We describe the case of an 
      acute GHB intoxication in a 28-year-old male who fell unconscious after ingestion 
      of a mouthful of an unknown beverage, and required medical support for 2 days. A 
      cocaine abuse was also detected by preliminary toxicological screening, but the 
      clinical presentation was not typical of cocaine intoxication. A simple 
      liquid-liquid extraction was used for quantitation of GHB, followed by 
      disilyl-derivatization and analysis in selective ion monitoring (SIM) mode by gas 
      chromatography-mass spectrometry (GC-MS), using GHB-d6 as internal standard. High 
      concentrations of GHB were detected in urine (3020 mg/L) and gastric contents 
      (71487 mg/L) at admission. After a 6-hours delay, GHB was still present in urine 
      at 2324 mg/L and in blood at 43 mg/L. The clinical symptoms of cocaine 
      intoxication were diminished by GHB consumption, and the cerebral scan was 
      modified. Attention must thus be paid to acute intoxications with surprising 
      clinical symptoms, and GHB has probably to be added to the preliminary 
      toxicological screening. Data available regarding GHB are briefly reviewed, and 
      our results are compared with previously published reports of non-fatal GHB 
      intoxication.
FAU - Bodson, Q
AU  - Bodson Q
AD  - Laboratoire de Toxicologie, Universite de Liege, CHU Sart-Tilman, Belgium. 
      Q.Bodson@ulg.ac.be
FAU - Denooz, R
AU  - Denooz R
FAU - Serpe, P
AU  - Serpe P
FAU - Charlier, C
AU  - Charlier C
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - England
TA  - Acta Clin Belg
JT  - Acta clinica Belgica
JID - 0370306
RN  - 0 (Hydroxybutyrates)
RN  - 30IW36W5B2 (4-hydroxybutyric acid)
RN  - I5Y540LHVR (Cocaine)
SB  - IM
MH  - Adult
MH  - Belgium
MH  - Cocaine/pharmacokinetics/*poisoning
MH  - Diagnosis, Differential
MH  - Drug Overdose/diagnosis/*metabolism
MH  - Gas Chromatography-Mass Spectrometry/*methods
MH  - Gastric Juice/*chemistry
MH  - Humans
MH  - *Hydroxybutyrates/analysis/blood/urine
MH  - Male
MH  - Substance Abuse Detection/*methods
EDAT- 2008/08/22 09:00
MHDA- 2008/09/24 09:00
CRDT- 2008/08/22 09:00
PHST- 2008/08/22 09:00 [pubmed]
PHST- 2008/09/24 09:00 [medline]
PHST- 2008/08/22 09:00 [entrez]
AID - 10.1179/acb.2008.033 [doi]
PST - ppublish
SO  - Acta Clin Belg. 2008 May-Jun;63(3):200-8. doi: 10.1179/acb.2008.033.