title: Intoxications due to ingestion of gamma-butyrolactone: organ distribution of gamma-hydroxybutyric acid and gamma-butyrolactone.
abstract: In Europe, the misuse of gamma-hydroxybutyric acid (GHB) and its analogues has increased within the recent years. Here, 2 fatalities and 1 nonfatal intoxication resulting from ingestion of gamma-butyrolactone (GBL), a precursor of GHB, are presented. GHB was quantified involving the conversion to GBL by application of a gas chromatography-mass spectrometry (GC/MS) method. Besides quantitation of GHB equivalents ("total GBL"), all specimens of case 1 were analyzed for the metabolic precursor GBL itself (absolute GBL). The cause of death in each case was attributed to GHB intoxication; the manner of death was suicide in the first case and accidental in the second one. Another yet nonfatal GHB intoxication was reported by an emergency department concerning a 36-year-old woman who was hospitalized due to her comatose state and loss of adverse effects reflexes. Here nail polish remover pads were used as source for GBL.
authors.affiliation: Institute of Legal Medicine, University of Cologne, Cologne, Germany. daniel.lenz@uk-koeln.de
authors.forename: Daniel
authors.initials: D
authors.lastname: Lenz
authors.forename: Markus A
authors.initials: MA
authors.lastname: Rothschild
authors.forename: Lars
authors.initials: L
authors.lastname: Kröner
mesh_terms: D015107:4-Butyrolactone / Q000009:adverse effects* / Q000097:blood / Q000493:pharmacokinetics*; D000328:Adult; D001921:Brain / Q000378:metabolism; D005260:Female; D006801:Humans; D006885:Hydroxybutyrates / Q000493:pharmacokinetics*; D008297:Male; D018482:Muscle, Skeletal / Q000378:metabolism; D019966:Substance-Related Disorders; D014018:Tissue Distribution
chemical_list: D006885:Hydroxybutyrates; C111420:4-hydroxybutyric acid; D015107:4-Butyrolactone