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Evaluation of the distribution of nicotine intravenous injection: an adult autopsy case report with a review of literature

We reported the first comprehensive autopsy case of death due to intravenous injection of nicotine. We examined the distribution of nicotine in the body tissues and fluid and exposed the pathophysiology of nicotine poisoning. A 19-year-old woman was rushed to the hospital in cardiorespiratory arrest...

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Autores principales: Aoki, Yayoi, Ikeda, Tomoya, Tani, Naoto, Shida, Alissa, Oritani, Shigeki, Ishikawa, Takaki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6949309/
https://www.ncbi.nlm.nih.gov/pubmed/30955048
http://dx.doi.org/10.1007/s00414-019-02035-y
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author Aoki, Yayoi
Ikeda, Tomoya
Tani, Naoto
Shida, Alissa
Oritani, Shigeki
Ishikawa, Takaki
author_facet Aoki, Yayoi
Ikeda, Tomoya
Tani, Naoto
Shida, Alissa
Oritani, Shigeki
Ishikawa, Takaki
author_sort Aoki, Yayoi
collection PubMed
description We reported the first comprehensive autopsy case of death due to intravenous injection of nicotine. We examined the distribution of nicotine in the body tissues and fluid and exposed the pathophysiology of nicotine poisoning. A 19-year-old woman was rushed to the hospital in cardiorespiratory arrest and was confirmed dead upon arrival. Liquid nicotine, hydrogen peroxide water, and a syringe were found in the hotel room where she stayed. On autopsy, nicotine concentration was the highest (15,023 μg/mg) in the tissue around the injection mark on the right upper arm. Among the body fluids, the intraperitoneal fluid had the highest, whereas the pericardial fluid had the lowest (0.736 μg/mL) nicotine concentration. Among the organs, the brain had the highest (11.637 μg/mg), whereas the fat tissue had the lowest (1.307 μg/mg) nicotine concentration. The concentration of cotinine, which is the metabolite of nicotine, was the highest in the tissue around the injection mark on the right arm (5.495 μg/mg) and was almost the same among the other body fluids and organs. The respective concentrations of nicotine and cotinine were 1.529 μg/mL and 0.019 μg/mL in the left heart blood and 3.157 μg/mL and 0.002 μg/mL in right heart blood. In this case, the nicotine concentrations in blood reached the lethal level. The distributions of nicotine and cotinine, as indicated by the intravenous injection, were related to the distribution of organs that metabolize nicotine and the distribution of nicotinic acetylcholine receptors.
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spelling pubmed-69493092020-01-23 Evaluation of the distribution of nicotine intravenous injection: an adult autopsy case report with a review of literature Aoki, Yayoi Ikeda, Tomoya Tani, Naoto Shida, Alissa Oritani, Shigeki Ishikawa, Takaki Int J Legal Med Case Report We reported the first comprehensive autopsy case of death due to intravenous injection of nicotine. We examined the distribution of nicotine in the body tissues and fluid and exposed the pathophysiology of nicotine poisoning. A 19-year-old woman was rushed to the hospital in cardiorespiratory arrest and was confirmed dead upon arrival. Liquid nicotine, hydrogen peroxide water, and a syringe were found in the hotel room where she stayed. On autopsy, nicotine concentration was the highest (15,023 μg/mg) in the tissue around the injection mark on the right upper arm. Among the body fluids, the intraperitoneal fluid had the highest, whereas the pericardial fluid had the lowest (0.736 μg/mL) nicotine concentration. Among the organs, the brain had the highest (11.637 μg/mg), whereas the fat tissue had the lowest (1.307 μg/mg) nicotine concentration. The concentration of cotinine, which is the metabolite of nicotine, was the highest in the tissue around the injection mark on the right arm (5.495 μg/mg) and was almost the same among the other body fluids and organs. The respective concentrations of nicotine and cotinine were 1.529 μg/mL and 0.019 μg/mL in the left heart blood and 3.157 μg/mL and 0.002 μg/mL in right heart blood. In this case, the nicotine concentrations in blood reached the lethal level. The distributions of nicotine and cotinine, as indicated by the intravenous injection, were related to the distribution of organs that metabolize nicotine and the distribution of nicotinic acetylcholine receptors. Springer Berlin Heidelberg 2019-04-07 2020 /pmc/articles/PMC6949309/ /pubmed/30955048 http://dx.doi.org/10.1007/s00414-019-02035-y Text en © The Author(s) 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Case Report
Aoki, Yayoi
Ikeda, Tomoya
Tani, Naoto
Shida, Alissa
Oritani, Shigeki
Ishikawa, Takaki
Evaluation of the distribution of nicotine intravenous injection: an adult autopsy case report with a review of literature
title Evaluation of the distribution of nicotine intravenous injection: an adult autopsy case report with a review of literature
title_full Evaluation of the distribution of nicotine intravenous injection: an adult autopsy case report with a review of literature
title_fullStr Evaluation of the distribution of nicotine intravenous injection: an adult autopsy case report with a review of literature
title_full_unstemmed Evaluation of the distribution of nicotine intravenous injection: an adult autopsy case report with a review of literature
title_short Evaluation of the distribution of nicotine intravenous injection: an adult autopsy case report with a review of literature
title_sort evaluation of the distribution of nicotine intravenous injection: an adult autopsy case report with a review of literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6949309/
https://www.ncbi.nlm.nih.gov/pubmed/30955048
http://dx.doi.org/10.1007/s00414-019-02035-y
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