FATAL POISONING WITH DETAJMIUM - IDENTIFICATION OF DETAJMIUM AND ITS METABOLITES AND ARTIFACTS BY GAS-CHROMATOGRAPHY MASS-SPECTROMETRY AND QUANTIFICATION BY HIGH-PERFORMANCE LIQUID-CHROMATOGRAPHY

After ingestion of an unknown dose of detajmium, a 14-year-old female collapsed with asystolia. Resuscitation efforts were not successful. A medicolegal autopsy was carried out, and blood, liver and gastric con tent were extracted and analyzed by gas chromatography-mass spectromet ry (GC-MS). After derivatization with acetic anhydride, detajmium and twelve of its derivatives and metabolites were identified. The main me tabolic pathways include hydroxylation and subsequent O-methylation of the indol ring, and oxidation as well as reduction of the C-21 hydrox yl function. Cleavage of the N-alkyl side-chain is a further, possibly non-enzymatic degradation pathway. Artifact formation induced by acet ylation included dehydratation of the hydroxyl function of C-21 and th e N-alkyl side-chain. The detajmium concentration in blood of the dece ased was determined by high-performance liquid chromatography with flu orimetric detection (12 mu g/ml).