Death after misuse of anabolic substances (clenbuterol, stanozolol and metandienone). (October 2019)

• Record Type: Journal Article
• Authors: Lehmann, Sabrina; Thomas, Andreas; Schiwy-Bochat, Karl-Heinz; Geyer, Hans; Thevis, Mario; Glenewinkel, Frank; Rothschild, Markus Alexander; Andresen-Streichert, Hilke; Juebner, Martin
• Is Part Of: Forensic science international. Volume 303(2019)
• Publication Date: 2019-10
• Subjects: Anabolic-androgenic steroids -- Clenbuterol -- Multi-drug abuse -- Death -- Bodybuilding -- Doping agents; Medical jurisprudence -- Periodicals; Chemistry, Forensic -- Periodicals; Forensic Medicine -- Periodicals; Médecine légale -- Périodiques; Chimie légale -- Périodiques; Gerechtelijke geneeskunde; Gerechtelijke chemie; Gerechtelijke psychiatrie; Chemistry, Forensic; Medical jurisprudence; Electronic journals; Periodicals; Electronic journals; 614.1
• DOI: 10.1016/j.forsciint.2019.109925
• Languages: English
• ISSNs: 0379-0738

Abstract

Highlights: Quantification of stanozolol and metandienone in post-mortem femoral blood. Detection of boldenone, clomiphene, trenbolone, clenbuterol, and drostanolone. Detection of clenbuterol in post-mortem femoral blood. Comprehensive literature review of clenbuterol. Abstract: A 34-year old male was found breathless and panting at home by his girlfriend three hours after a gym workout. Minutes later, he collapsed and died. Autopsy, histological and chemical analyses were conducted. The examination of the heart showed left ventricular hypertrophy, while the right coronary artery showed only a small vascular lumen (3 mm in diameter), due to its anatomical structure. In femoral blood concentrations of approx. 1 μg/L clenbuterol, approx. 56 μg/L stanozolol and approx. 8 μg/L metandienone, with trenbolone (<limit of quantification (LOQ)) were detected. Additionally, there were positive results in urine for boldenone, clomiphene, trenbolone, metandienone, stanozolol, clenbuterol and drostanolone, along with indications of testosterone and/or testosterone prohormones having been taken. In consideration of all aspects of this case, in can be assumed that the long-term consumption of anabolic androgen steroids (AAS) caused apparently pathological changes of the heart. Over and above, the combination of anatomical (small lumed coronary artery, ventricular hypertrophy) and substance-induced risk factors led to the fatal cardiovascular failure.