2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) poisoning in Victor Yushchenko: identification and measurement of TCDD metabolites.
BACKGROUND
2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) has a long half-life of 5-10 years in human beings as a result of its high lipophilicity, and little or no metabolism. We monitored TCDD, its form, distribution, and elimination in Victor Yushchenko after he presented with severe poisoning.


METHODS
In late December, 2004, a patient presented with TCDD poisoning; the levels in his blood serum (108000 pg/g lipid weight) were more than 50 000-fold greater than those in the general population. We identified TCDD and its metabolites, and monitored their levels for 3 years using gas chromatography and high-resolution mass spectrometry in samples of blood serum, adipose tissue, faeces, skin, urine, and sweat, after they were extracted and cleaned with different organic solvents.


RESULTS
The amount of unmodified TCDD in the samples that were analysed accounted for about 60% of TCDD eliminated from the body during the same period. Two TCDD metabolites-2,3,7-trichloro-8-hydroxydibenzo-p-dioxin and 1,3,7,8-tetrachloro-2-hydroxydibenzo-p-dioxin-were identified in the faeces, blood serum, and urine. The faeces contained the highest concentration of TCDD metabolites, and were the main route of elimination. Altogether, the different routes of elimination of TCDD and its metabolites accounted for 98% of the loss of the toxin from the body. The half-life of TCDD in our patient was 15.4 months.


CONCLUSIONS
This case of poisoning with TCDD suggests that the design of methods for routine assessment of TCDD metabolites in human beings should be a main aim of TCDD research in the metabolomic era.


BACKGROUND
University of Geneva Dermatology Fund, and Swiss Centre for Applied Human Toxicology.
Sorg
O
O
Dermato-Toxicology, Swiss Centre for Applied Human Toxicology, and Department of Dermatology, University Hospital, Geneva, Switzerland.
Zennegg
M
M
Schmid
P
P
Fedosyuk
R
R
Valikhnovskyi
R
R
Gaide
O
O
Kniazevych
V
V
Saurat
J-H
JH
D000273:Adipose Tissue / Q000737:chemistry; D001706:Biopsy; D004350:Drug Residues / Q000032:analysis / Q000378:metabolism; D017809:Fatal Outcome; D005243:Feces / Q000737:chemistry; D005554:Forensic Medicine / Q000379:methods*; D006207:Half-Life; D006708:Homicide; D006801:Humans; D008297:Male; D008875:Middle Aged; D011057:Politics; D000072317:Polychlorinated Dibenzodioxins / Q000032:analysis / Q000737:chemistry / Q000378:metabolism / Q000506:poisoning*; D015813:Substance Abuse Detection / Q000379:methods*; D013542:Sweat / Q000737:chemistry; D013997:Time Factors; D014455:Ukraine
D000072317:Polychlorinated Dibenzodioxins