title: Segmental hair testing to disclose chronic exposure to psychoactive drugs.
abstract: This study presents the case of a 4-year-old healthy child admitted to the paediatric ward for suspected accidental intoxication due to ingestion of narcoleptic drugs (methylphenidate, sertraline and quetiapine), taken on a regular basis by his 8-year-old brother affected by Asperger syndrome.Intoxication can be objectively assessed by measurements of drugs and metabolites in biological matrices with short-term (blood and urine) or long-term (hair) detection windows. At the hospital, the child's blood and urine were analysed by immunoassay (confirmed by liquid chromatography-mass spectrometry), and sertraline and quetiapine and their metabolites were identified. The suspicion that the mother administered drugs chronically prompted the analysis of six, consecutive 2-cm segments of the child's hair, using ultra-high performance liquid chromatography-tandem mass spectrometry, thereby accounting for ingestion over the previous 12 months. Quetiapine was found in the first four segments with a mean concentration of 1.00 ng/mg ± 0.94 ng/mg hair while sertraline and its metabolite, desmethyl-sertraline, were found in all segments with a mean concentration of 2.65 ± 0.94 ng/mg and 1.50 ± 0.94 ng/mg hair, respectively. Hair analyses were negative for methylphenidate and its metabolite (ritalinic acid). Biological matrices testing for psychoactive drugs disclosed both acute and chronic intoxication with quetiapine and sertraline administered by the mother.
authors.affiliation: Unidad de Abuso de Drogas y de Adicciones, Departamento de Investigación Terapéutica y Evaluación de Medicina, Instituto Superior de Sanidad, Roma.
authors.forename: Emilia
authors.initials: E
authors.lastname: Marchei
authors.forename: Ilaria
authors.initials: I
authors.lastname: Palmi
authors.forename: Simona
authors.initials: S
authors.lastname: Pichini
authors.forename: Roberta
authors.initials: R
authors.lastname: Pacifici
authors.forename: Ileana-Rita
authors.initials: IR
authors.lastname: Anton Airaldi
authors.forename: Juan Antonio
authors.initials: JA
authors.lastname: Costa Orvay
authors.forename: Joan
authors.initials: J
authors.lastname: García Serra
authors.forename: Bartolomé
authors.initials: B
authors.lastname: Bonet Serra
authors.forename: Óscar
authors.initials: Ó
authors.lastname: García-Algar
mesh_terms: D002675:Child, Preschool; D006197:Hair / Q000737:chemistry*; D006801:Humans; D008297:Male; D011619:Psychotropic Drugs / Q000032:analysis* / Q000506:poisoning*
chemical_list: D011619:Psychotropic Drugs