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Chloroquine Distribution in Postmortem Cases

NCJ Number
Journal of Forensic Sciences Volume: 36 Issue: 5 Dated: (September 1991) Pages: 1572-1579
J J Kuhlman; R W Mayes; B Levine; R Jones; G N Wagner; M L Smith
Date Published
8 pages
Chloroquine blood and tissue concentrations were examined for both overdose and non-overdose cases to determine interpretation of results in military aircraft fatalities. Twenty-nine literature overdose cases and 8 non-overdose literature cases were compared with this laboratory's findings.

Data are presented from 28 cases in which toxicological analysis identified chloroquine in postmortem specimens, but where it was not the cause of death. Twenty-three of the 28 were aircraft fatalities, and the remaining 5 cases were multiple injuries from other causes. Blood concentrations of the drug in 9 out of the 16 cases were 5.2 milligrams (mg)/liter (L); in overdose cases, the average concentration was 24 mg/L. Postmortem blood concentrations may be elevated relative to antemortem concentrations, but this does not necessarily indicate overdose. A comparison of tissue distribution of the AFIP cases with previously published data in both overdose and therapeutic cases suggests liver tissue is more suitable for interpretation of postmortem concentrations with 150 mg indicating an overdose. And brain tissue is not a suitable specimen for interpretation because of the great overlap between overdose and non-overdose cases in brain concentrations. These results indicate significant postmortem redistribution of chloroquine. Using the basis of these findings, 30 of the 34 published cases containing liver chloroquine and 19 of the 20 presented cases were properly identified. 4 tables and 22 references (Author abstract modified)


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