A case of intoxication with a new cathinone derivative α-PiHP - A presentation of concentrations in biological specimens

Introduction: Cathinones are currently the second largest and the second most frequently seized group of new psychoactive substances (NPS). One of the most recent synthetic cathinones that has appeared on the 'legal highs' market is alpha-pyrrolidinoisohexanophenone (alpha-PiHP). Case history: An 18-year-old man was found dead in an apartment. The autopsy materials were collected for toxicological analyses. Methods: The quantitative analyses were carried out by LC-MS/MS. Results: alpha-PiHP was detected and quantified in all post-mortem materials except the hair. The determined concentrations of the compound in the blood, urine and bile were 69 ng/mL, 2072 ng/mL, and 341 ng/mL respectively. The concentrations of a-PiHP in solid tissues were in the range of 7-478 ng/g. 4-Chloromethcathinone (4-CMC), N-ethylhexedrone, benzoylecgonine and 3,4-methylenedioxymethamphetamine (MDMA) were also detected in some materials. Discussion: No cases presenting concentrations of alpha-PiHP in biological materials have been reported so far. Due to the similarity of structures and the reported dosages, an attempt to compare the concentrations of alpha-PVP and alpha-PHP has been made. In the described case, functional death through intoxication of alpha-PiHP was accepted as the final cause of death. The other detected substances did not contribute to death due to their very likely distant administration. Conclusion: alpha-PiHP is another new synthetic cathinone that is a danger to the life of users. The described fatal intoxication case presents the concentrations of alpha-PiHP in post-mortem materials. This data could be valuable for further interpretation of other results from toxicological analyses in cases where the use of alpha-PiHP is suspected.