Paraquat Poisoning: Insights from Autopsy, Histology, and Liquid Chromatography with Tandem Mass Spectrometry in Multidisciplinary Forensic Toxicology Practice
Abstract
1. Introduction
2. Materials and Methods
2.1. Ethical Approval
2.2. Case Reports and Autopsies
Paraquat Concentration (µg/mL) | Number of Cases | Method of Detection | Reference | |||
---|---|---|---|---|---|---|
Blood | Urine | Gastric Content | Other Samples | |||
0.5–372.0 | N/A | N/A | N/A | 7 | LC-MS/MS | Present study |
0.3–2.2 (Heart) 1.0–1.6 (Peripheral) | 0.1–5.3 | 0.6–1.7 | 0.2–6.1 (Bile) 0.2 (Vitreous humor) | 4 | HPLC-MS/MS | [27] |
150.0 (Heart) 80.0 (Peripheral) | 910.0 | N/A | 320.0 (Bile) 60.0 (Vitreous humor) | 1 | HPLC-MS/MS | [28] |
291.5 * (2.9–1108.8) | N/A | 6028.3 * (3.0–21,617.2) | 200.0 (Vitreous humor) | 16 | LC-MS/MS | [23] |
3.3 * (0.1–9.5) | 3.0 * (0.1–13.5) | N/A | 4.1 * (0.5–11.9) (mg/g of lung) | 5 | GC-ion trap MS | [19] |
68.7 * (1.5–335.9) | N/A | N/A | N/A | 7 | HPLC (Liquid-Liquid-Extraction) | [32] |
5.1 | 6.0 | 17.2 | 80.6 (mg/kg of kidney) | 1 | HPLC-DAD | [33] |
30.1–636.6 | N/A | N/A | N/A | 24 | Spectrophotometry | [34] |
2.0 | 5.1 | N/A | 52.1 (µg/g of kidney) | 1 | HPLC | [25] |
7.9 * (0.2–25.0) | 192.0 | N/A | 41.5 * (0.3–146.0) (µg/g of liver) | 5 | HPLC ion-pair extraction | [35] |
7.2 * (1.1–13.3) | N/A | N/A | N/A | 3 | Spectrophotometry | [36] |
2.3. Toxicological Evaluation
2.3.1. Reagents
2.3.2. Preparation of Standards and Quality Control (QC) Samples
2.3.3. Forensic Sample Preparation
2.3.4. Method Validation
Linearity and Lower Limit of Quantification (LLOQ)
Accuracy and Precision
2.3.5. Procedure of Analysis and LC-MS/MS Instrumentation
3. Results
3.1. Demographic Characteristics, Autoptic, and Macroscopic Findings
3.2. Microscopic Histopathological Findings
3.3. PQ Quantification
3.3.1. Selectivity and Specificity
3.3.2. Linearity of Calibration and LLOQ
3.3.3. Accuracy and Precision
3.4. Application
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Chemicals | Precursor Ions (m/z) | Fragment Voltage (V) | Product Ions (m/z) | Collision Energy (V) |
---|---|---|---|---|
Ethyl viologen | 215.1 | 92 | 186.1 | 14 |
158.1 | 34 | |||
Paraquat | 187.1 | 92 | 172.1 | 18 |
156.1 | 46 |
Autopsy Case No. | Age | Gender | Weight (g) | Manner/Amount of Ingestion (mL) | Survival Time (Day) | |||||
---|---|---|---|---|---|---|---|---|---|---|
Brain | Heart | R/L Lung | Liver | Spleen | R/L Kidney | |||||
1 | 44 | M | N/A | 310 (~) | 740 (↑)/625 (↑) | 1515 (~) | 50 (~) | 100 (~)/110 (~) | Suicide/N/A | N/A |
2 | 45 | M | 1450 (↑) | 344 (~) | 710 (↑)/670 (↑) | 1560 (↑) | 105 (~) | 145 (↑)/135 (↑) | N/A | N/A |
3 | 39 | M | 1410 (~) | 535 (↑) | 1044 (↑)/1000 (↑) | N/A | N/A | N/A | Suicide/N/A | 1 |
4 | 44 | F | 1381 (↑) | 246 (~) | 1009 (↑)/728 (↑) | 1520 (↑) | 88 (~) | 141 (↑)/146 (↑) | N/A | 2 |
5 | 70 | F | 1120 (↓) | 295 (~) | 779 (↑)/553 (↑) | 1027 (↓) | 120 (~) | 140 (~)/115 (~) | N/A | N/A |
6 | 54 | M | 978 (~) | 253 (~) | 270 (~)/322 (~) | 1140 (~) | 87 (~) | 81 (~)/73 (~) | N/A/500 | 1 |
7 | 42 | M | 1356 (~) | 380 (↑) | 880 (↑)/773 (↑) | 1683 (↑) | 177 (↑) | 210 (↑)/225 (↑) | N/A | N/A |
Autopsy Case No. | Heart | Lung | Liver | Stomach/Intestine | Kidney |
---|---|---|---|---|---|
1 | Subendocardial, myocardial hemorrhage | Pulmonary edema, hemorrhage | Steatosis/necrosis, jaundice | Greenish blue color (lips, nose, larynx, trachea, stomach, intestine) | Acute kidney injury |
2 | N/A | Pulmonary edema, greenish blue color (trachea) | N/A | Greenish blue color (stomach, intestine) | N/A |
3 | Petechial hemorrhage, myocardial hemorrhage | Pulmonary congestion, hemorrhage | Steatosis | Gastritis | N/A |
4 | N/A | Severe pulmonary edema, intrapulmonary hemorrhage | Steatosis | Gastritis, mucosal hemorrhage, corrosive burn of esophagus | N/A |
5 | Congestion | Pulmonary fibrosis, edema, congestion | Jaundice | Mucosal damage | N/A |
6 | Petechial hemorrhage, coronary occlusion | Adhesion of all lobes, pulmonary hemorrhage | N/A | Erosion ulcer, petechial hemorrhage (esophagus, stomach), greenish-blue color (gastric content) | Acute kidney injury |
7 | N/A | Pulmonary edema, congestion | N/A | Gastritis | N/A |
Autopsy Case No. | Brain | Heart | Lung | Liver | Spleen | Kidney | Adrenal Gland | Esophagus/ Stomach |
---|---|---|---|---|---|---|---|---|
1 | N/A | Hemorrhage at subendocardial and myocardium | Edema | Steatosis | N/A | Partial autolysis | Partial autolysis | N/A |
2 | N/A | N/A | N/A | Steatosis | N/A | N/A | N/A | N/A |
3 | Subarachnoid congestion, hemorrhage, eosinophilic neurons | Thrombosis, myocardial necrosis, focal subendocardial hemorrhage, atherosclerosis | Diffuse alveolar damage, fibrin platelet thrombi | Multifocal ballooning degeneration (hepatocyte), steatosis | Congestion | Acute tubular necrosis, fibrin platelet thrombi in glomeruli | Focal cortical necrosis | Mucosal infarct, hemorrhage |
4 | N/A | N/A | Edema, congestion, petechial hemorrhage | Steatosis | Congestion | N/A | N/A | Mucosal hemorrhage, esophagitis |
5 | N/A | Atherosclerosis | Diffuse alveolar damage, hemorrhage, fibrosis | Cholestasis | N/A | Acute kidney injury | N/A | N/A |
6 | N/A | Myocardial infarction, coronary occlusion | Edema, congestion, petechial hemorrhage | N/A | N/A | N/A | Lipid depletion | Mucosal infarct, hemorrhage |
7 | Red blood cells within the subarachnoid space | Cardiomegaly, hemorrhage at myocardium | Edema, congestion, | Steatosis | Congestion | N/A | Lipid depletion of cortical cells | Superficial mucosal hemorrhage |
Nominal Concentration (ng/mL) | INTRA-DAY | Inter-Day | ||||||
---|---|---|---|---|---|---|---|---|
Mean Detected (ng/mL) | SD | Accuracy (%RR) | Precision (%CV) | Mean Detected (ng/mL) | SD | Accuracy (%RR) | Precision (%CV) | |
75.0 | 83.2 | 1.9 | 110.9 | 2.2 | 77.1 | 3.9 | 102.8 | 5.1 |
600.0 | 657.8 | 28.2 | 109.6 | 4.3 | 623.6 | 20.4 | 103.9 | 3.3 |
1500.0 | 1607.2 | 72.5 | 107.2 | 4.5 | 1517.7 | 104.9 | 101.2 | 6.9 |
Autopsy Case No. | Paraquat Concentration (µg/mL) |
---|---|
1 | 332.0 |
2 | 372.0 |
3 | 9.8 |
4 | 9.7 |
5 | 0.9 |
6 | 36.0 |
7 | 0.5 |
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Nuwongsa, I.; Markmee, T.; Pholpo, N.; Chockjamsai, M.; Monum, T.; Amornlertwatana, Y.; Tajai, P. Paraquat Poisoning: Insights from Autopsy, Histology, and Liquid Chromatography with Tandem Mass Spectrometry in Multidisciplinary Forensic Toxicology Practice. Toxics 2024, 12, 675. https://doi.org/10.3390/toxics12090675
Nuwongsa I, Markmee T, Pholpo N, Chockjamsai M, Monum T, Amornlertwatana Y, Tajai P. Paraquat Poisoning: Insights from Autopsy, Histology, and Liquid Chromatography with Tandem Mass Spectrometry in Multidisciplinary Forensic Toxicology Practice. Toxics. 2024; 12(9):675. https://doi.org/10.3390/toxics12090675
Chicago/Turabian StyleNuwongsa, Issarapong, Tanyarat Markmee, Nareerat Pholpo, Manoch Chockjamsai, Tawachai Monum, Yutti Amornlertwatana, and Preechaya Tajai. 2024. "Paraquat Poisoning: Insights from Autopsy, Histology, and Liquid Chromatography with Tandem Mass Spectrometry in Multidisciplinary Forensic Toxicology Practice" Toxics 12, no. 9: 675. https://doi.org/10.3390/toxics12090675
APA StyleNuwongsa, I., Markmee, T., Pholpo, N., Chockjamsai, M., Monum, T., Amornlertwatana, Y., & Tajai, P. (2024). Paraquat Poisoning: Insights from Autopsy, Histology, and Liquid Chromatography with Tandem Mass Spectrometry in Multidisciplinary Forensic Toxicology Practice. Toxics, 12(9), 675. https://doi.org/10.3390/toxics12090675