http://worldcat.org/entity/work/id/766878680

Ethanol origin in postmortem urine : an LC/MS determination of serotonin metabolites

Specimens from fatal aviation accident victims are submitted to the FAA Civil Aerospace Medical Institute for toxicological analysis. During toxicological evaluations, ethanol analysis is performed on all cases. Care must be taken when interpreting a positive ethanol result due to the potential for postmortem ethanol formation. Several indicators of postmortem ethanol formation exist; however, none are completely reliable. The consumption of ethanol has been shown to alter the concentration of two major serotonin metabolites, 5-hydroxytryptophol (5-HTOL) and 5-hydroxyindole-3-acetic acid (5-HIAA). While the 5-HTOL/5-HIAA ratio is normally very low, previous studies using live subjects have demonstrated that the urinary 5-HTOL/5-HIAA ratio is significantly elevated for 11 19 hours after acute ethanol ingestion. The authors investigated the 5-HTOL/5-HIAA ratio as a potential indicator of ethanol origin in postmortem urine samples. They developed and validated a method for the simultaneous determination of 5-HTOL and 5-HIAA in forensic urine samples using a simple liquid/liquid extraction and LC/MS/MS and LC/MS/MS/MS. A typical recovery of approximately 80% was achieved for both compounds. The LC/MS method proved highly selective and sensitive, having an LOD of 0.1 ng/mL for both compounds. The accuracy and precision also were very good. Utilizing their LC/MS method, they examined the 5-HTOL/5-HIAA ratio in 21 ethanol-negative and 23 true ethanol-positive postmortem urine specimens. They found that all ethanol-negative specimens had 5-HTOL/5-HIAA ratios below 15 pmol/nmol, a previously established antemortem urine cutoff for recent ethanol ingestion. All ethanol-positive urine samples had 5-HTOL/5-HIAA ratios above 15 pmol/nmol. These results validated the antemortem cutoff for use with postmortem urine specimens. This method was then applied to cases where postmortem ethanol formation was suspected. (10 figures, 41 refs.).

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