title: A case of suicide by self-injection of adrenaline.
abstract: Adrenaline (epinephrine) auto-injectors provide life-saving pre-hospital treatment for individuals experiencing anaphylaxis in a community setting. Errors in handling adrenaline auto-injectors, particularly by children and healthcare professionals, have been reported. Reports of adrenaline overdoses are limited in the medical literature. In most of these cases, accidental adrenaline administration results from medical error. Exogenous administration of catecholamine is responsible for cardiovascular and metabolic responses, which may cause supraventricular tachycardia, ventricular dysrhythmias and myocardial ischemia. The authors present a unique autopsy case involving a 34 year-old woman who intentionally self-injected adrenaline using an adrenaline auto-injector as part of a suicide plan. Catecholamines and metanephrines were measured in peripheral and cardiac blood as well as urine and vitreous humor. Based on the results of all postmortem investigations, the cause of death was determined to be cardiac dysrhythmia and cardiac arrest following adrenaline self-injection.
authors.affiliation: CURML, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland, cristian.palmiere@chuv.ch.
authors.forename: Cristian
authors.initials: C
authors.lastname: Palmiere
authors.forename: Fabien
authors.initials: F
authors.lastname: Bévalot
authors.forename: Daniel
authors.initials: D
authors.lastname: Malicier
authors.forename: Eric
authors.initials: E
authors.lastname: Grouzmann
authors.forename: Tony
authors.initials: T
authors.lastname: Fracasso
authors.forename: Laurent
authors.initials: L
authors.lastname: Fanton
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000139:chemically induced; D002395:Catecholamines / Q000032:analysis; D004837:Epinephrine / Q000008:administration & dosage* / Q000009:adverse effects*; D005260:Female; D006323:Heart Arrest / Q000139:chemically induced; D006801:Humans; D007273:Injections, Intramuscular; D013405:Suicide; D013566:Sympathomimetics / Q000008:administration & dosage* / Q000009:adverse effects*; D014822:Vitreous Body / Q000737:chemistry
chemical_list: D002395:Catecholamines; D013566:Sympathomimetics; D004837:Epinephrine