title: A case of fatal intoxication from metformin.
abstract: A case of fatal intoxication from metformin is presented. The decedent was an obese 58-year-old-woman with type II diabetes, in whom severe lactic acidosis secondary to metformin accumulation was precipitated by acute renal failure. She had been on metformin 500 mg twice a day. Postmortem blood was deproteinated with acetonitrile, washed with dichloromethane, and the resulting supernatant injected into high-performance liquid chromatography system. Separation was performed on a analytical 125 x 4 mm i.d. RP-8 column. The wavelength was set at 235 nm. The mobile phase was acetonitrile (40%), sodium lauryl sulfate, and sodium dihydrogen phosphate adjusted to pH 5.1 (60%) at a flow rate of 1.0 mL/min. The concentration of metformin in postmortem blood was 77.3 microg/mL. The qualitative result was also confirmed by LC/APCI/MS/MS analysis.
authors.affiliation: Institute of Pharmaceutical and Toxicological Chemistry, University of Milan, Viale Abruzzi 42, 20131 Milano, Italy. veniero.gambaro@unimi.it
authors.forename: Veniero
authors.initials: V
authors.lastname: Gambaro
authors.forename: Lucia
authors.initials: L
authors.lastname: Dell'acqua
authors.forename: Fiorenza
authors.initials: F
authors.lastname: Farè
authors.forename: Marco
authors.initials: M
authors.lastname: Fidani
authors.forename: Rino
authors.initials: R
authors.lastname: Froldi
authors.forename: Elisa
authors.initials: E
authors.lastname: Saligari
mesh_terms: D000140:Acidosis, Lactic / Q000139:chemically induced*; D058186:Acute Kidney Injury / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D017809:Fatal Outcome; D005260:Female; D053593:Forensic Toxicology; D006801:Humans; D007004:Hypoglycemic Agents / Q000097:blood / Q000506:poisoning* / Q000627:therapeutic use; D008687:Metformin / Q000097:blood / Q000506:poisoning* / Q000627:therapeutic use; D008875:Middle Aged
chemical_list: D007004:Hypoglycemic Agents; D008687:Metformin