Bromazepam intoxication in an infant: contribution of hair and nail analysis

AbstractA 5 ‐week‐old infant was admitted to the pediatric emergency department with agitation and incessant crying. Investigations led to a diagnosis of rhabdomyolysis following coma due to severe bromazepam intoxication (blood concentration 656 μg/L). The infant was hospitalized and his condition rapidly improved. Ten days later, an inquiry was opened to determine whether he could have been repeatedly intoxicated since birth. A lock of hair, nail cuttings and the last diaper used were sampled. The hair of the mother was also sampled to test for possible exposurein utero. Samples were measured by liquid chromatography/tandem mass spectrometry after decontamination. Bromazepam was found at concentrations of 63 pg/mg in hair and 4 pg/mg in fingernails. It was also detected in two diaper samples. The hair of the mother did not contain bromazepam, excluding exposurein utero. Nail analysis can complete or replace hair analysis when hair is not available. As the time to appearance of the molecules in keratin matrices is uncertain at that age, it could be useful to take a first sample of nails at day 0 (when intoxication was presumed to have occurred) and then at a later stage. Lastly, quantitative interpretation must remain extremely prudent.
Source: Drug Testing and Analysis - Category: Drugs & Pharmacology Authors: Tags: CORRESPONDENCE CASE REPORT Source Type: research