Death from Naphthalene Poisoning Manifesting as Toxic Hepatitis: An Autopsy Case.

Choi, Jinhyuk; Park, Seong Hwan; Park, Min Jee; Jeon, Seok Hoon

doi:2017.41.4.137

Korean J Leg Med > Volume 41(4); 2017 > Article

Case Report

Korean Journal of Legal Medicine 2017;41(4):137-140.
DOI: https://doi.org/10.7580/kjlm.2017.41.4.137 Published online November 30, 2017.

Death from Naphthalene Poisoning Manifesting as Toxic Hepatitis: An Autopsy Case.

Jinhyuk Choi, Seong Hwan Park, Min Jee Park, Seok Hoon Jeon

¹Department of Legal Medicine, Korea University College of Medicine, Seoul, Korea.
²Division of Forensic Medicine, National Forensic Service, Seoul, Korea.
³Seoul Clinic of Korea Forensic Investigation, Seoul, Korea. hyuk929@naver.com

Abstract

Suicide through naphthalene poisoning is rare. Prolonged hemolytic anemia and hemoglobinuria are typical symptoms of naphthalene poisoning. We report an unusual case of naphthalene poisoning. The decedent was an 87-year-old female who intentionally ingested over 5 g of naphthalene. After more than 5 hours, she was found in a drowsy state. During initial examination, hemoglobin level and urine test results were normal. Aspartate aminotransferase and alanine aminotransferase levels were elevated (854 and 1,197 U/L, respectively). Metabolic acidosis was found on arterial blood gas analysis. The patient was treated conservatively by administration of activated charcoal, calcium gluconate, insulin, and glucose. However, the patient died after 1 day of hospital admission. On autopsy, the liver showed toxic hepatitis with confluent necrosis. Naphthalene concentrations in the blood and gastric contents were 5.4 and 5.8 mg/L, respectively. In conclusion, the decedent ingested naphthalene and died due to liver failure without hemolysis.

Key Words: Toxic hepatitis, Naphthalenes, Autopsy