Fatal intoxication with methcathinone (ephedrone) in a 16-year-old girl – a clinical case
Keywords:
synthetic cathinones, methcathinone, ephedrone, fatal intoxication, toxicological analysisAbstract
Introduction: Methcathinone (MCAT) is a synthetic cathinone derivative with potent psychostimulant activity whose toxic effects may resemble those of amphetamine intoxication. Reports of acute and fatal MCAT poisonings worldwide remain limited. The aim of this paper is to present a case of fatal MCAT intoxication in an underage female patient. Case description: A 16-year-old girl developed sudden severe illness characterized by fever, tachycardia, metabolic acidosis, coagulopathy, and multiple organ failure, resulting in death less than four hours after hospital admission. Clinical, laboratory, and toxicological investigations were performed. Toxicological analysis: Confirmatory GC-MS analysis of biological samples collected both ante- and postmortem verified the presence of MCAT. No other narcotic or toxic substances were detected. Discussion: The clinical presentation and analytical findings were initially nonspecific but consistent with an acute sympathomimetic crisis induced by MCAT. The low MCAT concentrations in the blood samples (2 ng/mL antemortem; 7 ng/mL postmortem) demonstrate that quantitative results alone cannot determine the lethality of the substance. Conclusions: MCAT is a high-risk psychostimulant with potential for sudden lethal outcome even after a single (incident) use. Intensive clinical monitoring is essential in young patients with suspected acute intoxication with psychoactive substances.
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