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Alimemazine

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Bernardino Barcelo – 1st expert on this subject based on the ideXlab platform

  • Alimemazine poisoning as evidence of munchausen syndrome by proxy a pediatric case report
    Forensic Science International, 2016
    Co-Authors: Isabel Gomila, Victoria Lopezcorominas, Manuela Pellegrini, Loreto Quesada, Elena Miravet, Simona Pichini, Bernardino Barcelo

    Abstract:

    Munchausen syndrome by proxy (MSBP), also known as fabricated or induced illness in a child by a caretaker, is a form of abuse where a caregiver deliberately produces or feigns illness in a person under his or her care, so that the proxy will receive medical care that gratifies the caregiver. The affected children are often hospitalized for long periods and endure repetitive, painful and expensive diagnostic attempts. We present an analytically confirmed case of MSBP by Alimemazine. A 3-year-old boy was brought repetitively to a Pediatric Emergency Department by his mother because he presented limb tremors, dysarthria, obnubilation, and ataxia and generalized tonic-clonic seizures coinciding with intermittent fever. Neither the rest of the physical examination nor the complementary tests showed any significant alterations. MSBP was suspected and a routine systematic toxicological analysis in urine and blood was requested. Alimemazine was detected in all biological samples. The administration of this drug was never mentioned by the mother and the subsequent interview with her corroborated the suspicion of MSBP. Clinically, after separation from the mother, the child’s neurological symptoms gradually improved until the complete disappearance of the cerebellar symptoms. Alimemazine was quantified in serum, urine, gastric content and cerebrospinal fluid samples by gas chromatography-mass spectrometry (maximum serum level was 0.42μg/ml). Hair quantification of Alimemazine was performed by ultra-performance liquid chromatography-tandem mass spectrometry in different segments of hair. The results confirmed regular substance use during the at least eight last months (8.8, 14.7, 19.7 and 4.6ng/mg hair starting from most proximal segment). This patient represents the first case published with analytical data of Alimemazine in blood, urine, gastric content, cerebrospinal fluid and hair, which allowed us to prove an acute and repetitive poisoning with Alimemazine as evidence of MSBP.

Pascal Kintz – 2nd expert on this subject based on the ideXlab platform

  • Sudden death with clozapine and refractory schizophrenia: a case study
    , 2020
    Co-Authors: Frédéric Aknouche, Gérald Quatrehomme, Emilie Guibert, Matthieu Eyraud, Robert Buti, Kévin Fargeot, Pascal Kintz

    Abstract:

    necessary. During the autopsy, a toxicity-induced pulmonary oedema was observed. Results: Toxicology tests showed that blood concentrations following administration of prescribed doses were outside the usual therapeutic ranges found. In the femoral blood, the concentration of loxapine was 65 ng/mL, clozapine was at 660 ng/mL, Alimemazine was at 250 ng/mL and cyamemazine was at 540 ng/mL. Conclusion: The prescription, in terms of prescribed doses, associa- tion of drugs and monitoring, was consistent with the state of the art. The hypothesis of taking added drugs is the most likely. The cause of death was ruled as a sudden death from a deleterious cardiovascular effect.

  • Determination of trimeprazine-facilitated sedation in children by hair analysis.
    Journal of Analytical Toxicology, 2006
    Co-Authors: Pascal Kintz, Marion Villain, Vincent Cirimele

    Abstract:

    Trimeprazine or Alimemazine is largely used as an antipruritic agent, but it is also used for insomnia, cough, and oral premedication in pediatric day surgery. The first cases involving repetitive sedation linked to the use of trimeprazine as a drug-facilitated crime and subsequent impairment of two children are reported. Because of the long delay between the alleged crime and clinical examination, collection of blood or urine was of little value. This is the reason why the laboratory developed an original approach based on hair testing by liquid chromatography-tandem mass spectrometry. A strand of hair from each child was sampled about 2 months after the first suspicion of administration and was cut into small segments. After cutting into small pieces, 20 mg of hair was incubated overnight in a phosphate buffer (pH 8.4). The aqueous phase was extracted by 5 mL of a mixture of diethyl ether/methylene chloride (80:20) in presence of diazepam-d(5) used as the internal standard (IS). Hair extract was separated on a XTerra MS C18 column using a gradient of acetonitrile and formate buffer. Detection was based on two daughter ions: transitions m/z 299.3 to 299.0 and 100.0 and m/z 289.9 to 154.0 for trimeprazine and the IS, respectively. In the hair of the two subjects, trimeprazine was detected at concentrations in the range 23 to 339 pg/mg. The stepmother, who was the perpetrator in both cases, did not challenge the use of trimeprazine as a sedative drug. Language: en

  • a fatal case of Alimemazine poisoning
    Journal of Analytical Toxicology, 1995
    Co-Authors: Pascal Kintz, F Berthault, A Tracqui, P Mangin

    Abstract:

    Alimemazine, a phenothiazine derivative with the properties of antihistamines, was determined by a selective high-performance liquid chromatographic technique in blood and tissues from a postmortem case. The blood concentration of Alimemazine was 6.52 pg/mL. The brain was the major site of drug deposition, and tissue distribution is discussed in light of the existing literature. empty blisters of Th~ral~ne (Alimemazine, 5-mg tablets) were found near his bed. Autopsy findings were unremarkable, and they showed no evidence of violence. No samples were taken for histology. The following postmortem samples were taken for toxicological analysis: femoral blood, urine, gastric contents, bile, liver, muscle (psoas), brain, kidney, and heart.

P Mangin – 3rd expert on this subject based on the ideXlab platform

  • a fatal case of Alimemazine poisoning
    Journal of Analytical Toxicology, 1995
    Co-Authors: Pascal Kintz, F Berthault, A Tracqui, P Mangin

    Abstract:

    Alimemazine, a phenothiazine derivative with the properties of antihistamines, was determined by a selective high-performance liquid chromatographic technique in blood and tissues from a postmortem case. The blood concentration of Alimemazine was 6.52 pg/mL. The brain was the major site of drug deposition, and tissue distribution is discussed in light of the existing literature. empty blisters of Th~ral~ne (Alimemazine, 5-mg tablets) were found near his bed. Autopsy findings were unremarkable, and they showed no evidence of violence. No samples were taken for histology. The following postmortem samples were taken for toxicological analysis: femoral blood, urine, gastric contents, bile, liver, muscle (psoas), brain, kidney, and heart.