Fatal metformin overdose: case report and postmortem biochemistry contribution.

Details

Serval ID
serval:BIB_8601A1368B8B
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Fatal metformin overdose: case report and postmortem biochemistry contribution.
Journal
International Journal of Legal Medicine
Author(s)
Bonsignore A., Pozzi F., Fraternali Orcioni G., Ventura F., Palmiere C.
ISSN
1437-1596 (Electronic)
ISSN-L
0937-9827
Publication state
Published
Issued date
2014
Peer-reviewed
Oui
Volume
128
Number
3
Pages
483-492
Language
english
Notes
Publication types: Journal Article Publication Status: ppublish PDF : Case report
Abstract
Metformin is an oral antihyperglycemic agent used in the management of type 2 diabetes mellitus. Lactic acidosis from metformin overdose is a rare complication of metformin therapy and occurs infrequently with therapeutic use. Fatal cases, both accidental and intentional, are extremely rare in clinical practice. Metformin is eliminated by the kidneys, and impaired renal function can result in an increased plasma concentration of the drug. In this report, we describe an autopsy case involving a 70-year-old woman suffering from diabetes mellitus and impaired renal function who received metformin treatment. Metformin concentrations in the peripheral blood collected during hospitalization and femoral blood collected during autopsy were 42 and 47.3 µg/ml, respectively. Lactic acidosis (29.10 mmol/l) was objectified during hospitalization. Furthermore, postmortem biochemistry allowed ketoacidosis to be diagnosed (blood β-hydroxybutyrate, 10,500 µmol/l). Death was attributed to lactic acidosis due to metformin intoxication. Increased plasma concentrations of the drug were attributed to severely impaired renal function. The case emphasizes the usefulness of performing exhaustive toxicology and postmortem biochemistry towards the more complete understanding of the pathophysiological mechanisms that may be involved in the death process.
Pubmed
Web of science
Create date
06/06/2014 16:33
Last modification date
20/08/2019 14:45
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