Analysis of metformin in antemortem serum and postmortem specimens by a novel HPLC method and application to an intoxication case.
A case of intoxication from the oral hypoglycemic drug metformin is presented. A number of published liquid chromatographic methods were combined to enable a simplified analysis of metformin in both antemortem and postmortem specimens. The method involved direct injection of a protein-free filtrate into the liquid chromatograph. The method was sufficiently sensitive to detect therapeutic use of metformin; no common therapeutic or abused drugs interfered with the assay. In the presented case, the hospital admission serum metformin concentration was 141 mg/L, or approximately two orders of magnitude above therapeutic concentrations. The medical examiner concluded that the cause of death in this case was metformin intoxication, and the manner of death was suicide.
Moore
Karla A
KA
Office of the Chief Medical Examiner, State of Maryland, 111 Penn Street, Baltimore, Maryland 21201, USA.
Levine
Barry
B
Titus
Jack M
JM
Fowler
David R
DR
D000284:Administration, Oral; D002851:Chromatography, High Pressure Liquid; D062787:Drug Overdose; D017809:Fatal Outcome; D005554:Forensic Medicine; D006801:Humans; D007004:Hypoglycemic Agents / Q000032:analysis / Q000097:blood* / Q000506:poisoning*; D008297:Male; D008687:Metformin / Q000032:analysis / Q000097:blood* / Q000506:poisoning*; D008875:Middle Aged; D011180:Postmortem Changes; D013405:Suicide
D007004:Hypoglycemic Agents; D008687:Metformin