Citation

Uezono T, Shiono H, Shimizu K, Ogawa K, Saito O, Yoshida M, Mizukami H, Matsubara K. Leg. Med. (Elsevier) 2002; 4(1): 34-36.

Copyright

(Copyright © 2002, Japanese Society of Legal Medicine, Publisher Elsevier Publishing)

DOI

10.1016/S1344-6223(01)00042-6

PMID

unavailable

Abstract

A 5-year-old girl was given a sulfonylurea hypoglycemic agent, 25 mg of glibenclamide (ten tablets of Euglucon) with two benzodiazepine drugs, 2 mg of estazoram and 0.75 mg of triazolam (one tablet of Eurodin and three tablets of Halcion), by her 37-year-old pharmacist father and then injected with 70 units of insulin (NovoLet 40R). She died several hours after the injection of insulin. Autopsy was carried out 12 h after the death. A glibenclamide level of 103 ng/ml was detected in the serum collected from the heart at autopsy. The serum insulin and C-peptide concentrations were 295 μU/ml and 0.5 ng/ml, respectively. The high level of insulin and the low level of C-peptide indicated that most of the serum insulin was exogenous. The determination of the serum C-peptide concentration was useful to the diagnosis of hypoglycemia caused by exogenous insulin even in the case of co-administration with an endogenous-insulin-releasing agent. © 2002 Elsevier Science Ireland Ltd. All rights reserved.

Language: en

Keywords

adult; antidiabetic agent; article; benzodiazepine derivative; C peptide; C-Peptide; cardiopulmonary arrest; cause of death; consciousness; diagnostic value; dose response; drug blood level; drug determination; drug fatality; estazolam; female; glibenclamide; Glibenclamide; heart; homicide; Homicide; human; hypoglycemia; Hypoglycemia; hypoglycemic coma; injection; insulin; Insulin; insulin blood level; male; novolet 40r; protein blood level; school child; self injection; serum; suicide; sulfonylurea derivative; tablet; triazolam