A fatal case of poisoning with a cathinone derivative: α-PiHP and its postmortem distribution in body fluids and organ tissues

New psychoactive substances continue to appear on the drug market, and alpha-pyrrolidinoisohexanophenone (alpha-PiHP) is one of the most popular cathinone derivatives. In this article, we report a case of death caused by alpha-PiHP. Based on the toxicological results of the studied case along with autopsy, histopathological findings and crime-scene information, fatal intoxication with alpha-PiHP was accepted as the final cause of death. alpha-PiHP and its metabolite (OH-alpha-PiHP) were detected and quantified in all postmortem materials (blood collected from the heart, the femoral vein and the dural venous sinuses; vitreous humor; cerebrospinal fluid; cerebral cortex; brainstem; cerebellum; bile; liver; kidney; heart; pancreas; spleen; thyroid gland; lung; adipose tissue; stomach and intestine). To date, this is the first case of determination of alpha-PiHP and its metabolite in postmortem specimens. In our opinion, alpha-PiHP and its metabolite concentration database can be helpful in the interpretation of fatal cases.

Automated summary

This article presents a case of death caused by alpha-PiHP, a popular cathinone derivative. The analysis of toxicological results, autopsy, histopathological findings, and crime-scene information confirmed fatal intoxication with alpha-PiHP as the cause of death. Alpha-PiHP and its metabolite (OH-alpha-PiHP) were detected and quantified in various postmortem materials, making this the first case of determination of these substances in postmortem specimens. The authors believe that a database of alpha-PiHP and its metabolite concentrations can be useful in interpreting fatal cases.