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Chighine A, Porcu M, Ferino G, Lenigno N, Trignano C, d'Aloja E, Locci E. Infant urinary metabolomic profile in a fatal acute methadone intoxication. Int J Legal Med 2022; 136:569-575. [PMID: 35018499 PMCID: PMC8847265 DOI: 10.1007/s00414-021-02772-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 12/29/2021] [Indexed: 11/25/2022]
Abstract
A case report suspicious for a Sudden Infant Death Syndrome is here described. Pathological findings were consistent with an acute respiratory failure while toxicological analysis revealed an elevated blood methadone concentration. Death was then ascribed to an acute methadone intoxication. In addition to the routinary approach, the urinary sample collected at autopsy was investigated with a 1H NMR metabolomic approach and the identified metabolomic profile was challenged with the urinary metabolomic profiles previously obtained from 10 newborns who experienced perinatal asphyxia and 16 healthy control newborns. Intriguingly, the urinary profile of the methadone intoxicated infant was very similar to those belonging to the perinatal asphyxia newborns, especially to those belonging to the newborns characterised by the worst outcome. The results offer several hints on a shared metabolic derangement between different mechanisms of asphyxia/hypoxia. To the best of the authors’ knowledge, this is the first report of the use of a metabolomic approach in a pathological case, in which metabolomics offers useful additional information regarding the mechanism and the cause of death.
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Affiliation(s)
- Alberto Chighine
- Department of Medical Sciences and Public Health, Section of Legal Medicine, University of Cagliari, Cittadella Universitaria Di Monserrato, 09042, Monserrato, Cagliari, Italy.
| | - Michele Porcu
- Department of Medical Sciences and Public Health, Section of Radiology, University of Cagliari, Cagliari, Italy
| | - Giulio Ferino
- Department of Medical Sciences and Public Health, Section of Legal Medicine, University of Cagliari, Cittadella Universitaria Di Monserrato, 09042, Monserrato, Cagliari, Italy
| | - Nicola Lenigno
- Department of Medical Sciences and Public Health, Section of Legal Medicine, University of Cagliari, Cittadella Universitaria Di Monserrato, 09042, Monserrato, Cagliari, Italy
| | - Claudia Trignano
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Ernesto d'Aloja
- Department of Medical Sciences and Public Health, Section of Legal Medicine, University of Cagliari, Cittadella Universitaria Di Monserrato, 09042, Monserrato, Cagliari, Italy
| | - Emanuela Locci
- Department of Medical Sciences and Public Health, Section of Legal Medicine, University of Cagliari, Cittadella Universitaria Di Monserrato, 09042, Monserrato, Cagliari, Italy
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