Unclear loss of consciousness after clobutinol intake.
The case of a 13-month-old boy with a diagnosis of unclear unconsciousness is reported on. As the physical examination did not lead to any explanation of his condition, the administration of drugs in the context of Munchausen syndrome by proxy was suspected. Complex forensic-toxicological analyses using HPLC/UV, LC/MS/MS, and GC/MS identified ambroxol and clobutinol, two drugs that are indicated for acute respiratory diseases. No other central active compounds were detected. The accusation of intentional bodily injury raised against the parents could be rebutted, since the boy's unconsciousness could be explained with a rare but harmful side effect of the antitussive clobutinol.
Kirschbaum
Katrin M
KM
Institute of Forensic Medicine, Rheinische Friedrich-Wilhelms-University, Stiftsplatz 12, D-53111 Bonn, Germany. katrin.kirschbaum@ukb.uni-bonn.de
Musshoff
Frank
F
Madea
Burkhard
B
D000551:Ambroxol / Q000008:administration & dosage / Q000009:adverse effects / Q000032:analysis; D000605:Amino Alcohols / Q000008:administration & dosage / Q000009:adverse effects* / Q000032:analysis; D000996:Antitussive Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000032:analysis; D002853:Chromatography, Liquid; D003951:Diagnostic Errors; D005100:Expectorants / Q000008:administration & dosage / Q000009:adverse effects / Q000032:analysis; D053593:Forensic Toxicology; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D007223:Infant; D008297:Male; D016735:Munchausen Syndrome by Proxy / Q000175:diagnosis; D014474:Unconsciousness / Q000139:chemically induced*
D000605:Amino Alcohols; D000996:Antitussive Agents; D005100:Expectorants; C544688:desmethylclobutinol; C017135:clobutinol; D000551:Ambroxol