title: Fatal intoxication with labetalol (Trandate).
abstract: The dead body of a 44-year-old woman, previously known for depression and alcoholism, has been discovered at her place of residence by her husband. A forensic autopsy has been carried out. The results indicated unspecific histological lesions (alveolar oedema, liver steatosis and interstitial nephritis) but did not reveal any apparent cause of death. Several boxes of medicines have been found near the body, justifying a toxicological analysis. This has been performed on peripheral blood and urine samples using liquid chromatography with diode array and mass spectrometric detections, in conjunction with gas chromatography coupled with mass spectrometry. Ethanol has been found (1.24 g/L in blood, 2.63 g/L in urine and 1.33 g/kg in gastric content), as well as therapeutic concentrations of meprobamate (14.1mg/L) and low concentrations of nordazepam (0.12 mg/L) in blood. On the other hand, particularly high levels of labetalol, a widely used beta-blocker, have been found both in blood (1.7 mg/L) and urine (20.2mg/L), which led us to measure labetalol levels in available viscera samples (liver, heart, kidney, and lung) and gastric content. Measured concentrations were 14.2 microg/g, 7.8 microg/g, 5.4 microg/g, 5.2 microg/g and 31.1 microg/g, respectively. We describe here the first report of a fatal intoxication attributed to labetalol that is linked to its acute toxicity, with tissue distribution of this beta-blocker.
authors.affiliation: Laboratory of Pharmacology and Toxicology, Raymond Poincaré Universitary Hospital, AP-HP, 104 Boulevard Raymond Poincaré, 92380 Garches, France.
authors.forename: Stanislas
authors.initials: S
authors.lastname: Grassin Delyle
authors.forename: Charlotte
authors.initials: C
authors.lastname: Duverneuil-Mayer
authors.forename: Emuri
authors.initials: E
authors.lastname: Abe
authors.forename: Bertille
authors.initials: B
authors.lastname: Mathieu
authors.forename: Geoffroy
authors.initials: G
authors.lastname: Lorin De La Grandmaison
authors.forename: Philippe
authors.initials: P
authors.lastname: Charlier
authors.forename: Jean Claude
authors.initials: JC
authors.lastname: Alvarez
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000032:analysis / Q000506:poisoning*; D000328:Adult; D005260:Female; D053593:Forensic Toxicology; D008401:Gas Chromatography-Mass Spectrometry; D005766:Gastrointestinal Contents / Q000737:chemistry; D006801:Humans; D007668:Kidney / Q000737:chemistry; D007741:Labetalol / Q000032:analysis / Q000506:poisoning*; D008099:Liver / Q000737:chemistry; D008168:Lung / Q000737:chemistry; D009206:Myocardium / Q000737:chemistry
chemical_list: D000319:Adrenergic beta-Antagonists; D007741:Labetalol