Top

Published in:

01-05-2006 | Technical Note

Sudden death after isobutane sniffing: a report of two forensic cases

Authors: H. Pfeiffer, M. Al Khaddam, B. Brinkmann, H. Köhler, J. Beike

Published in: International Journal of Legal Medicine | Issue 3/2006

Abstract

The intentional inhalation of a volatile substance (“sniffing”) causing euphoria and hallucinations is an under-recognised form of substance abuse in children and adolescents with a high morbidity and mortality. Sudden death can be caused by cardiac arrhythmia, asphyxia or trauma. Two fatal cases of isobutane sniffing of cigarette lighter refill containing isobutane are reported. Toxicological investigations revealed the presence of isobutane in the heart blood and brain tissue of both cases (case 1: heart blood 0.1 μg/g, brain tissue 2.3 μg/g; case 2: heart blood 4.6 μg/g, brain tissue 17.4 μg/g) and the presence of its metabolite 2-methyl-2-propanol in the heart blood of both cases (0.5 and 1.8 μg/g, respectively). The histological investigations of the inner organs showed similar results in both victims. Autopsy findings, results of the histological and immunohistochemical investigations, toxicological findings and analytical procedures are discussed.

Adgey AA, Johnston PW, McMechan S (1995) Sudden cardiac death and substance abuse. Resuscitation 29:219–221CrossRefPubMed

Ago M, Ago K, Ogata M (2002) A fatal case of n-butane poisoning after inhaling anti-perspiration aerosol deodorant. Leg Med 4:113–118CrossRef

Bass M (1970) Sudden sniffing death. JAMA 212:2075–2079CrossRefPubMed

Bouche MP, Lambert WE, Van Bocxlaer JF, Piette MH, Leenheer AP (2002) Quantitative determination of n-propane, iso-butane, and n-butane by headspace GC-MS in intoxications by inhalation of lighter fluid. J Anal Toxicol 26:35–42PubMed

Brinkmann B, Fechner G, Püschel K (1983b) Zur Ultrastrukturpathologie des Alveolarapparates beim experimentellen Ertrinken. Z Rechtsmed 91:47–60CrossRefPubMed

Fineschi V, Neri M, Riezzo I, Turilazzi E (2004) Sudden cardiac death due to hypersensitivity myocarditis during clozapine treatment. Int J Legal Med 118:307–309CrossRefPubMed

Flanagan R, Ruprah M, Meredith T, Ramsey J (1990) An introduction to the clinical toxicology of volatile substances. Drug Saf 5:359–383PubMedCrossRef

Janssen W (1984) Forensic histopathology. Springer, Berlin, Heidelberg, New York, pp 224–233

Karger B, Lorin de la Grandmaison G, Bajanowski T, Brinkmann B (2004) Analysis of 155 consecutive forensic exhumations with emphasis on undetected homicides. Int J Legal Med 118:90–94CrossRefPubMed

10.

Ortmann C, Pfeiffer H, Brinkmann B (2000) A comparative study on the immunohistochemical detection of early myocardial damage. Int J Legal Med 113:215–220CrossRefPubMed

11.

Park J, Min J-S, Heo S, Lim M-A, Park S-W (2005) Quantification of propane in biological material by head-space GC. Forensic Sci Int 151:165–170CrossRefPubMed

12.

Pfeiffer H, Weiss FU, Karger B, Aghdassi A, Lerch MM, Brinkmann B (2004) Fatal cerebro-renal oxalosis after appendectomy. Int J Legal Med 118:98–100CrossRefPubMed

13.

Pfeiffer H, Varchmin-Schultheiss K, Brinkmann B (2005) Sudden death in childhood due to varicella pneumonia—a forensic case report with clinical implications. Int J Legal Med (Epub ahead of print)

14.

Rohrig T (1997) Sudden death due to butane inhalation. Am J Forensic Med Pathol 18:299–302CrossRefPubMed

15.

Römhild W, Logemann E, Schmitt G, Alt A, Krebs K, Bartels H, Pedal I, Schmidt U, Beck N, Krause D (2004) Analyse von Propan/Isobutan/n-Butan in vier Todesfällen. In: Pragst F, Aderjan R (Hrsg) GTFCh—Symposium 2003 Ausgewählte Aspekte der Forensischen Toxikologie. Verlag Dr. Dieter Helm. Heppenheim, 109–122

16.

Segal E, Wason S (1990) Sudden death caused by inhalation of butane and propane. N Engl J Med 323:1638PubMed

17.

Shepherd RT (1989) Mechanism of sudden death associated with volatile substance abuse. Hum Toxicol 8:287–291PubMed

18.

Sugie H, Sasaki C, Hashimoto C, Takeshita H, Nagai T, Nakamura S, Furukawa M, Nishikawa T, Kurihara K (2004) Three cases of sudden death due to butane or propane gas inhalation: analysis of tissues for gas components. Forensic Sci Int 143:211–214CrossRefPubMed

19.

Tsukamoto S, Chiba S, Muto T, Ishikawa T, Shimamura M (1985) Study on the metabolism of volatile hydrocarbons in mice—propane, n-butane, and iso-butane. J Toxicol Sci 4:323–332

20.

Wehner F, Benz D, Wehner H-D (2002) Tödliche Inhalation von Butan–Propan–Gas. Arch Kriminol 209:165–168

Title: Sudden death after isobutane sniffing: a report of two forensic cases
Authors: H. Pfeiffer
M. Al Khaddam
B. Brinkmann
H. Köhler
J. Beike
Publication date: 01-05-2006
Publisher: Springer-Verlag
Published in: International Journal of Legal Medicine / Issue 3/2006
Print ISSN: 0937-9827
Electronic ISSN: 1437-1596
DOI: https://doi.org/10.1007/s00414-005-0062-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Sudden death after isobutane sniffing: a report of two forensic cases

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 3/2006

Ancestry vs physical traits: the search for ancestry informative markers (AIMs)

Early increase in TNF-alpha-containing mast cells in skin lesions

Black thyroid

Study of six X-linked tetranucleotide microsatellites: population data from five Spanish regions

More genetic studies on the inference of ancestry and morphological traits: response from the authors to the letter from Salas et al.

Maximum intensity projection of cranial computed tomography data for dental identification