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Death From Butane Inhalation Abuse in Teenagers: Two New Case Studies and Review of the Literature
Authors:Véronique Alunni MD  PhD  Yvan Gaillard PharmD  PhD  François Castier MD  Marie‐Dominique Piercecchi‐Marti MD  PhD  Gérald Quatrehomme MD  PhD
Institution:1. Forensic Pathology and Forensic Anthropology Department, Faculté de Médecine, Institut Universitaire d'Anthropologie Médico‐légale, Nice Cedex 2, France;2. Laboratory of Analytical Toxicology, La Voulte sur Rh?ne, France;3. Department of Forensic Medicine and Medical Law, ADES UMR 7268, Aix‐Marseille University, CNRS, EFS, Marseille, France
Abstract:The ready availability of butane makes butane abuse frequent. Fatalities are rare. This study presents two cases of death by butane overdose. The postmortem analyses were carried out using headspace gas chromatography–mass spectrometry. It revealed femoral blood butane concentrations of 18 and 22 mg/L, respectively, as well as specific combinations of adjuvants in each victim. In one of the victims, brain and fatty tissue also contained butane, pointing to chronic consumption. The originality of this study is to show that the identification of specific combinations of adjuvants can be helpful for identifying the brand of deodorant used. Also, sampling the skin and mucosa can help identify the method of drug delivery. The histological examination documented both the direct toxic effect of the gas on the respiratory mucosa and signs of chronic abuse. Volatile substance intoxications should be systematically considered in case of sudden death in a teenager.
Keywords:forensic science  volatile solvent abuse  butane  chronic abuse  sudden death syndrome  aerosol propellant gas inhalation
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