title: False negative on a proven involuntary intoxication in two children with lorazepam.
abstract: Children aged between 1 to 4 years are the most at risk of unintentional poisonings. Benzodiazepines are the most medicine often cause of the poisoning. Among the twenty-two most prescribed benzodiazepines in France, lorazepam ranks fifth behind zolpidem, alprazolam, bromazepam and zopiclone. However the automated assay currently available does not allow to detect and/or to quantify lorazepam. The alternative to the immunoassay is the liquid chromatography coupled with mass spectrometry (HPLC/MS). This technique, highly sensitive and specific, requires a pre-treatment phase and a good technical proficiency, justifying specialized staff. The clinical cases presented here illustrate the major interest of availability to this type of technology in routine and 24h/24h.
authors.affiliation: Laboratoire de pharmacologie et toxicologie, Hôpital Maison Blanche, CHU de Reims, Reims, France, SFR Cap-Santé-EA3801-Université de Reims, Laboratoire de pharmacologie médicale, Faculté de médecine de Reims, Reims, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Feliu
authors.affiliation: Laboratoire de pharmacologie et toxicologie, Hôpital Maison Blanche, CHU de Reims, Reims, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Guillemin
authors.affiliation: Laboratoire de pharmacologie et toxicologie, Hôpital Maison Blanche, CHU de Reims, Reims, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Gozalo
authors.affiliation: Laboratoire de pharmacologie et toxicologie, Hôpital Maison Blanche, CHU de Reims, Reims, France.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Fouley
authors.affiliation: Laboratoire de pharmacologie et toxicologie, Hôpital Maison Blanche, CHU de Reims, Reims, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Marty
authors.affiliation: Laboratoire de pharmacologie et toxicologie, Hôpital Maison Blanche, CHU de Reims, Reims, France, SFR Cap-Santé-EA3801-Université de Reims, Laboratoire de pharmacologie médicale, Faculté de médecine de Reims, Reims, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Millart
authors.affiliation: Laboratoire de pharmacologie et toxicologie, Hôpital Maison Blanche, CHU de Reims, Reims, France, SFR Cap-Santé-EA3801-Université de Reims, Laboratoire de pharmacologie médicale, Faculté de médecine de Reims, Reims, France.
authors.forename: Zoubir
authors.initials: Z
authors.lastname: Djerada
mesh_terms: D001774:Blood Chemical Analysis / Q000379:methods* / Q000592:standards; D002649:Child Abuse / Q000175:diagnosis; D002675:Child, Preschool; D002853:Chromatography, Liquid; D005188:False Negative Reactions; D005260:Female; D005602:France; D006801:Humans; D008140:Lorazepam / Q000506:poisoning*; D008297:Male; D013058:Mass Spectrometry; D020258:Neurotoxicity Syndromes / Q000097:blood / Q000175:diagnosis; D035781:Siblings
chemical_list: D008140:Lorazepam
keywords: child; false negative; involountary poisoning; lorazepam