Poisoning suicide with ingestion of the pyrethroids alpha-cypermethrin and deltamethrin and the antidepressant mirtazapine: A case report.

This case report describes a death attributed to the intake of the pyrethroid insecticides, alpha-cypermethrin and deltamethrin, and the antidepressant mirtazapine. The autopsy findings showed absence of external traumatic injuries and internal generalized visceral congestion, edema and cyanosis. The toxicological results revealed the presence of a toxic concentration of mirtazapine (12.5mg/L and 10.7mg/L in blood and urine, respectively) and high concentrations of pyrethroids (2.46mg/L alpha-cypermethrin and 2.40mg/L deltamethrin in blood, and 0.41mg/L alpha-cypermethrin and 0.46mg/L deltamethrin in urine, respectively). Blood ethanol concentration was 0.75g/L. All the evidence - from autopsy, police investigation and toxicology - was consistent with the intentional self-harm of the deceased. The current case was determined and recorded as a poisoning suicide. Cause of death of the deceased was reported as the synergistic toxicity of the ingested pyrethroids and mirtazapine. The presence of a significant blood ethanol concentration was considered a secondary contributory factor to the fatal outcome. The case presented herein is the first death attributed to poisoning from ingestion of pyrethroids in combination with mirtazapine, with the intention of the victim to cause self-harm, with corresponding toxicology results.

Residues of selected polychlorinated biphenyls (PCB) and organochlorine pesticides (OCP) in postmortem lungs from Epirus, northwestern Greece.

Organochlorine (OC) pesticides and polychlorinated biphenyls (PCB) are compounds characterized as persistent organic pollutants (POP) in the environment. These compounds are monitored globally since they enter the human body and accumulate in tissues, resulting in consequent adverse effects. In this study concentrations of selected OC compounds were determined in human autopsy lungs from Epirus, a relatively restricted region in northwestern Greece. This is the first epidemiologic study from Greece reporting on monitoring of environmental pollutants in human autopsy material. Thirty lungs collected from that number of autopsy cases were analyzed: 19 males and 11 females. The age range was 14-91 yr (mean ± SD = 61.8 ± 22.5 yr). Twenty-two cases (73%) were positive for at least one pollutant and eight cases were negative (27%). PCB were the most abundant class of contaminants, detected in 15 out of the 30 cases (50%). Dichlorodiphenyltrichloroethane (DDT) and hexachlorocyclohexanes (HCH) were second and third in abundance with 9 (30%) and 8 (27%) positive cases, respectively. The frequency of detection showed a tendency to increase with age of individuals. The patterns of OC found in human autopsy lungs were similar to those reported previously for other human specimens. Our results demonstrated a similar trend in contamination sources and distribution has occurred in western Greece as noted globally.

Determination of organochlorine pesticides and polychlorinated biphenyls in post-mortem human lung by matrix solid-phase dispersion with the aid of response surface methodology and desirability function.

A matrix solid-phase dispersion (MSPD) method for the simultaneous determination of 20 organochlorine pesticides (OCPs) (aldrin, endrin, dieldrin, α-BHC, ß-BHC, γ-BHC, δ-BHC, α-chlordane, γ-chlordane, p,p'-DDE, p,p'-DDT, p,p'-DDD, endosulfan I, endosulfan II, endosulfan sulfate, endrin aldehyde, heptachlor, heptachlor epoxide, endrin ketone and methoxychlor) and six polychlorinated biphenyl (PCB) congeners (PCB 28, 52, 101, 138, 153 and 180) in post-mortem human lung has been developed and validated. Response surface methodology (RSM) and desirability function were employed to optimize the extraction conditions of MSPD. Extraction was carried out using Florisil (2.0 g) as the sorbent material as well as clean-up adsorbent (1.5401 g), n-hexane:dichloromethane (11:89, v/v) as the eluting solvent (15.45 mL) and Na2SO4 (2.0 g) as dehydrating agent. Determination and quantification of OCPs and PCBs residues were carried out using a gas chromatograph equipped with an electron capture detector (GC-ECD). A mass spectrometric detector (GC-MS) in the selected ion monitoring (SIM) mode was also used for confirmation purposes. Method detection limits by GC-MS ranged from 0.42 to 0.87 ng g⁻¹ and 0.51 to 1.35 ng g⁻¹, for OCPs and PCBs, respectively. Lower detection limits were calculated for GC-ECD ranging between 0.15-0.30 ng g⁻¹ and 0.18-0.48 ng g⁻¹, respectively. Relative standard deviations did not exceed 9%. Analytes provided recoveries ranging from 65% to 106%. The proposed method was successfully applied to the analysis of lung tissues from six autopsy cases.