Skip to main content

Advertisement

SpringerLink
Log in

Death due to acute tetrachloroethylene intoxication in a chronic abuser

  • Case Report
  • Published:
International Journal of Legal Medicine Aims and scope Submit manuscript

Abstract

Volatile substances are used widespread, especially among young people, as a cheap and easily accessible drug. Tetrachloroethylene is one of the solvents exerting effects on the central nervous system with experiences of disinhibition and euphoria. The case presented is that of a 27-year-old female, found dead by her father at home with cotton swabs dipped in the nostrils. She was already known for this type of abuse and previously admitted twice to the hospital for nonfatal acute poisonings. The swabs were still soaked in tetrachloroethylene. Toxicological and histological investigations demonstrated the presence of an overlap between chronic intake of the substance (with high concentrations in sites of accumulation, e.g., the adipose tissue, and contemporary tissue damage, as histologically highlighted) and acute intoxication as final cause of death, with a concentration of 158 mg/L in cardiac blood and 4915 mg/kg in the adipose tissue. No other drugs or medicines were detected in body fluids or tissues, and to our knowledge, this is the highest concentration ever detected in forensic cases. This peculiar case confirms the toxicity of this substance and focuses on the importance of complete histological and toxicological investigations in the distinction between chronic abuse and acute intoxication.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

We’re sorry, something doesn't seem to be working properly.

Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.

References

  1. Wax PM, Brooks DE (2003) Dry cleaning. In: Occupational, Industrial, and Environmental Toxicology, 2nd edn. Greenberg MI. Ed. Mosby, pp 104–117

  2. Gold LS, De Roos AJ, Waters M, Stewart P (2008) Systematic literature review of uses and levels of occupational exposure to tetrachloroethylene. J Occup Environ Hyg 5:807–839

    Article  CAS  PubMed  Google Scholar 

  3. Isenschmid DS, Cassin BJ, Hepler BR, Kanluen S (1998) Tetrachloroethylene intoxication in an autoerotic fatality. J Forensic Sci 43:231–234

    CAS  PubMed  Google Scholar 

  4. Wille SM, Lambert WE (2004) Volatile substance abuse—post-mortem diagnosis. Forensic Sci Int 142:135–156

    Article  CAS  PubMed  Google Scholar 

  5. Baselt RC (2011) Disposition of toxic drugs and chemicals in man, 9th edn. Biomedical Publications, Foster City, CA

  6. Savolainen H, Pfäffli P, Tengén M, Vainio H (1977) Biochemical and behavioural effects of inhalation exposure to tetrachlorethylene and dichlormethane. J Neuropathol Exp Neurol 36:941–949

    Article  CAS  PubMed  Google Scholar 

  7. Morimatsu Y, Ishitake T, Irie K, Hara K, Sakamoto T, Aizawa H (2006) Acute pulmonary injury due to exposure to a high concentration of trichloroethylene vapor. Occup Health 48:271–272

    Article  CAS  Google Scholar 

  8. Takaki A, Suzuki H, Iwasaki Y, Takigawa T, Ogino K, Matsuda H, Yagi T, Hanazaki M, Nakatsuka H, Katayama H, Matsumi M, Shoji B, Terada R, Kobashi H, Sakaguchi K (2008) A 27-year-old man who died of acute liver failure probably due to trichloroethylene abuse. J Gastroenterol 43:239–242

    Article  PubMed  Google Scholar 

  9. Shen C, Zhao CY, Liu F, Wang YD, Wang W (2011) Acute liver failure associated with occupational exposure to tetrachloroethylene. J Korean Med Sci 26:138–142

    Article  PubMed Central  PubMed  Google Scholar 

  10. Lash LH, Parker JC (2001) Hepatic and renal toxicities associated with perchloroethylene. Pharmacol Rev 53:177–208

    CAS  PubMed  Google Scholar 

  11. Emara AM, Abo El-Noor MM, Hassan NA, Wagih AA (2010) Immunotoxicity and hematotoxicity induced by tetrachloroethylene in Egyptian dry cleaning workers. Inhal Toxicol 22:117–124

    Article  CAS  PubMed  Google Scholar 

  12. Salahudeen AK (1998) Perchloroethylene-induced nephrotoxicity in dry-cleaning workers: is there a role for free radicals? Nephrol Dial Transplant 13:1122–1124

    Article  CAS  PubMed  Google Scholar 

  13. Kobayashi S, Hutcheon DE, Regan J (1982) Cardiopulmonary toxicity of tetrachloroethylene. J Toxicol Environ Health 10:23–30

    Article  CAS  PubMed  Google Scholar 

  14. Delepoulle F, Chauvière A, Brevière GM, Martinot A, Francart C, Diependaele JF, Leclerc F (1989) Congestive cardiomyopathy after chronic inhalation of trichloroethylene. Arch Fr Pediatr 46:599–600

    CAS  PubMed  Google Scholar 

  15. Oshiro WM, Krantz QT, Bushnell PJ (2004) A search for residual behavioral effects of trichloroethylene (TCE) in rats exposed as young adults. Neurotoxicol Teratol 26:239–251

    Article  CAS  PubMed  Google Scholar 

  16. MacIver MB (2009) Abused inhalants enhance GABA-mediated synaptic inhibition. Neuropsychopharmacology 34:2296–2304

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  17. Perrin MC, Opler MG, Harlap S, Harkavy-Friedman J, Kleinhaus K, Nahon D, Fennig S, Susser ES, Malaspina D (2007) Tetrachloroethylene exposure and risk of schizophrenia: offspring of dry cleaners in a population birth cohort, preliminary findings. Schizophr Res 90:251–254

    Article  PubMed Central  PubMed  Google Scholar 

  18. Benignus VA, Bushnell PJ, Boyes WK, Eklund C, Kenyon EM (2009) Neurobehavioral effects of acute exposure to four solvents: meta-analyses. Toxicol Sci 109:296–305

    Article  CAS  PubMed  Google Scholar 

  19. Bale AS, Barone S Jr, Scott CS, Cooper GS (2011) A review of potential neurotoxic mechanisms among three chlorinated organic solvents. Toxicol Appl Pharmacol 255:113–126

    Article  CAS  PubMed  Google Scholar 

  20. Lock EA, Zhang J, Checkoway H (2013) Solvents and Parkinson disease: a systematic review of toxicological and epidemiological evidence. Toxicol Appl Pharmacol 266:345–355

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. Paulu C, Aschengrau A, Ozonoff D (1999) Tetrachloroethylene-contaminated drinking water in Massachusetts and the risk of colon-rectum, lung, and other cancers. Environ Health Persp 107:265–71

  22. Levine B, Fierro MF, Goza SW, Valentour JC (1981) A tetrachloroethylene fatality. J Forensic Sci 26(1):206–209

    CAS  PubMed  Google Scholar 

  23. Gaillard Y, Billault F, Pépin G (1995) Tetrachloroethylene fatality: case report and simple gas chromatographic determination in blood and tissues. Forensic Sci Int 76:161–168

    Article  CAS  PubMed  Google Scholar 

  24. Dehon B, Humbert L, Devisme L, Stievenart M, Mathieu D, Houdret N, Lhermitte M (2000) Tetrachloroethylene and trichloroethylene fatality: case report and simple headspace SPME-capillary gas chromatographic determination in tissues. J Anal Toxicol 24:22–26

    Article  CAS  PubMed  Google Scholar 

  25. Hartez HT (1987) Myocarditis: the Dallas criteria. Hum Pathol 18:619–624

    Article  Google Scholar 

  26. Yarema MC, Becker CE (2005) Key concepts in postmortem drug redistribution. Clin Toxicol (Phila) 43:235–241

    Article  CAS  Google Scholar 

  27. Lukaszewski T (1979) Acute tetrachloroethylene fatality. Clin Toxicol 15:411–415

    Article  CAS  PubMed  Google Scholar 

  28. Musshoff F, Padosch S, Steinborn S, Madea B (2004) Fatal blood and tissue concentrations of more than 200 drugs. Forensic Sci Int 142:161–210

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare no conflicts of interest.

Author information

Authors and Affiliations

  1. Sezione di Medicina Legale e delle Assicurazioni, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 37, Milano, Italy

    Alberto Amadasi, Lavinia Mastroluca, Laura Marasciuolo, Guendalina Gentile & Riccardo Zoja

  2. Sezione di Tossicologia Forense, Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, Università degli Studi di Milano, Via Luigi Mangiagalli 37, Milano, Italy

    Marina Caligara & Luca Sironi

Authors
  1. Alberto Amadasi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lavinia Mastroluca
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Laura Marasciuolo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Marina Caligara
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Luca Sironi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Guendalina Gentile
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Riccardo Zoja
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alberto Amadasi.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Amadasi, A., Mastroluca, L., Marasciuolo, L. et al. Death due to acute tetrachloroethylene intoxication in a chronic abuser. Int J Legal Med 129, 487–493 (2015). https://doi.org/10.1007/s00414-015-1143-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00414-015-1143-0

Keywords

Search

Navigation