A case of fatal intoxication from metformin.
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.
Gambaro
Veniero
V
Institute of Pharmaceutical and Toxicological Chemistry, University of Milan, Viale Abruzzi 42, 20131 Milano, Italy. veniero.gambaro@unimi.it
Dell'acqua
Lucia
L
Farè
Fiorenza
F
Fidani
Marco
M
Froldi
Rino
R
Saligari
Elisa
E
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
D007004:Hypoglycemic Agents; D008687:Metformin