Acute intoxication with aniline: detection of acetaminophen as aniline metabolite

A 47-year-old woman unwittingly ingested an unknown substance together with her breakfast coffee. She suffered effects such as strong headache, genera lized cyanosis, and a burning sensation of the lips and collapsed some minu tes later. After admission into hospital a methemoglobin level of 35% was d etermined in the blood. Treatment by administration of tolonium chloride (t oluidine blue! resulted in complete recovery of the patient. The toxic agen t was identified as aniline by GC with mass selective detection after organ ic solvent extraction and 11 h after ingestion the plasma aniline level was 0.13 mg/l. Acetanilide (0.79 mg/ml) and acetaminophen (2.3 mg/ml) were ide ntified in plasma as metabolites of aniline. It was assumed that a high met abolic capacity for acetylation protected the victim from more seven reacti ons. Her husband confessed later that he had tried to poison her.