PMID- 32369164
OWN - NLM
STAT- MEDLINE
DCOM- 20201223
LR  - 20201223
IS  - 1945-2403 (Electronic)
IS  - 0146-4760 (Linking)
VI  - 44
IP  - 8
DP  - 2020 Dec 12
TI  - MDMA Intoxication in a Potential Organ Donor with Cardiac Arrest.
PG  - 923-926
LID - 10.1093/jat/bkaa042 [doi]
AB  - Amphetamine and its derivatives' consumption is still an important public health 
      issue, namely in terms of compounds variability and disposition to consumers. 
      However, some of them, like 3,4-methylenedioxymethamphetamine (MDMA), still live 
      in the illicit market, with continuous success. Nevertheless, there is always new 
      information and data on MDMA intoxication, both in vivo and in postmortem 
      context. The authors report an intoxication case with MDMA, in an 18-year-old 
      male, considered a potential organ donor after a cardiac arrest. Whole blood 
      samples were collected in vivo, at the emergency room (ER), and postmortem, at 
      the National Institute of Legal Medicine and Forensic Sciences. After a general 
      screening procedure, samples were extracted by solid phase extraction (OASIS(R) 
      MCX), followed by gas chromatography-mass spectrometry analysis. The whole blood 
      postmortem sample was positive for lidocaine (<500 ng/mL), compatible with the ER 
      intervention, and positive for MDMA (2278 ng/mL) and methylenedioxyamphetamine 
      (MDA) (49 ng/mL), while whole blood samples collected in vivo (during the 
      maintenance of the individual under advanced life support), were positive for 
      MDMA (504-1918 ng/mL) and MDA (20-89 ng/mL). Samples were negative for other 
      substances, namely ethanol, other drugs of abuse and medicines. Results 
      interpretation is pivotal to understand the behavior of the substance. Thus, in 
      this case, MDMA postmortem behavior should be carefully evaluated, considering as 
      possible influencers, in the specific context of the case, the time lapse between 
      death verification, maintenance of the advanced life support and body 
      manipulation for organ collection purposes. Also referred and discussed is the 
      antemortem/postmortem ratio of MDMA obtained values, compared with literature 
      references. There is no doubt that death was due to MDMA intoxication, but 
      information from the analysis performed on the in vivo samples suggests that this 
      type of sample should also be considered, in a complementary role, whenever 
      possible.
CI  - (c) The Author(s) 2020. Published by Oxford University Press on behalf of Society 
      of Forensic Toxicologists, Inc. All rights reserved. For permissions, please 
      e-mail: journals.permissions@oup.com.
FAU - Castro, Andre L
AU  - Castro AL
AD  - National Institute of Legal Medicine and Forensic Sciences, Forensic Chemistry 
      and Toxicology Service, Jardim Carrilho Videira, 4050-067, Porto, Portugal.
AD  - Abel Salazar Biomedical Sciences Institute, University of Porto, Rua de Jorge 
      Viterbo Ferreira, 228, 4050-313 Porto, Portugal.
FAU - Tarelho, Sonia
AU  - Tarelho S
AD  - National Institute of Legal Medicine and Forensic Sciences, Forensic Chemistry 
      and Toxicology Service, Jardim Carrilho Videira, 4050-067, Porto, Portugal.
FAU - Almeida, Dina
AU  - Almeida D
AD  - Abel Salazar Biomedical Sciences Institute, University of Porto, Rua de Jorge 
      Viterbo Ferreira, 228, 4050-313 Porto, Portugal.
AD  - National Institute of Legal Medicine and Forensic Sciences, Forensic Clinical and 
      Pathology Service, Jardim Carrilho Videira, 4050-067, Porto, Portugal.
FAU - Sousa, Lara
AU  - Sousa L
AD  - National Institute of Legal Medicine and Forensic Sciences, Forensic Chemistry 
      and Toxicology Service, Jardim Carrilho Videira, 4050-067, Porto, Portugal.
FAU - Franco, Joao Miguel
AU  - Franco JM
AD  - National Institute of Legal Medicine and Forensic Sciences, Forensic Chemistry 
      and Toxicology Service, Jardim Carrilho Videira, 4050-067, Porto, Portugal.
FAU - Teixeira, Helena M
AU  - Teixeira HM
AD  - Department of Research, Training and Documentation, National Institute of Legal 
      Medicine and Forensic Sciences, Coimbra, Polo das Ciencias de Saude (Polo III) - 
      Azinhaga de Santa Comba 3000-548 Coimbra, Portugal.
AD  - Faculty of Medicine, University of Coimbra, Polo das Ciencias de Saude (Polo III) 
      - Azinhaga de Santa Comba 3000-548 Coimbra, Portugal.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - England
TA  - J Anal Toxicol
JT  - Journal of analytical toxicology
JID - 7705085
RN  - 0 (Hallucinogens)
RN  - 4764-17-4 (3,4-Methylenedioxyamphetamine)
RN  - CK833KGX7E (Amphetamine)
RN  - KE1SEN21RM (N-Methyl-3,4-methylenedioxyamphetamine)
SB  - IM
MH  - 3,4-Methylenedioxyamphetamine
MH  - Adolescent
MH  - Amphetamine
MH  - *Drug Overdose
MH  - Forensic Medicine
MH  - Gas Chromatography-Mass Spectrometry
MH  - Hallucinogens
MH  - Heart Arrest/*metabolism
MH  - Humans
MH  - Male
MH  - N-Methyl-3,4-methylenedioxyamphetamine/*metabolism/toxicity
MH  - Substance Abuse Detection
MH  - *Tissue Donors
EDAT- 2020/05/06 06:00
MHDA- 2020/12/29 06:00
CRDT- 2020/05/06 06:00
PHST- 2020/06/04 00:00 [received]
PHST- 2020/06/27 00:00 [revised]
PHST- 2020/09/22 00:00 [accepted]
PHST- 2020/05/06 06:00 [pubmed]
PHST- 2020/12/29 06:00 [medline]
PHST- 2020/05/06 06:00 [entrez]
AID - 5829849 [pii]
AID - 10.1093/jat/bkaa042 [doi]
PST - ppublish
SO  - J Anal Toxicol. 2020 Dec 12;44(8):923-926. doi: 10.1093/jat/bkaa042.