Severe clinical toxicity caused by 25I-NBOMe confirmed analytically using LC-MS-MS method

  • Wojciech Waldman Department of Clinical Toxicology, Medical University of Gdansk, Gdansk, Poland Pomeranian Center of Toxicology, Gdansk, Poland
  • Maria Kała Institute of Forensic Research, Krakow, Poland
  • Wojciech Lechowicz Institute of Forensic Research, Krakow, Poland
  • Dominika Gil Institute of Forensic Research, Krakow, Poland
  • Jacek Sein Anand Department of Clinical Toxicology, Medical University of Gdansk, Gdansk, Poland Pomeranian Center of Toxicology, Gdansk, Poland


Rhabdomyolysis is a relatively rare, but potentially serious
complication of various diseases. Muscular injury
and resultant release of electrolytes, myoglobin and
other enzymatic proteins e.g. creatine kinase (CK) into
circulation may result in multi-organ failure requiring an
extensive treatment. Non-traumatic causes of rhabdomyolysis,
like poisonings, appear to be much more frequent
than traumatic causes. We present the case of a patient
who developed exceptionally massive rhabdomyolysis,
with CK up to 516 455 U/l, after ingestion of a relatively
small dose of a novel psychoactive substance known
as “Alice in Wonderland”. Laboratory quantification was
performed using a validated LC-MS/MS method in a
whole blood sample.

Author Biography

Wojciech Waldman, Department of Clinical Toxicology, Medical University of Gdansk, Gdansk, Poland Pomeranian Center of Toxicology, Gdansk, Poland
Wojciech Waldman is an Assistant Professor of Clinical Toxicology at the Medical University of Gdańsk. He received his doctorate in Medical Science from Medical University of Gdańsk. His recent publications include:
Poisoning deaths in Poland: types and frequencies reported in Łódź, Kraków, Sosnowiec, Gdańsk, Wrocław and Poznań during 2009-2013. Int. J. Occup. Med. Environ. Health 2017; 30, 897-908.
Hyperventilation with maintenance of isocapnia. An "old new" method in carbon monoxide intoxication. PLoS ONE 2017; 12, 1-8.
Psychosis associated with acute recreational drug toxicity: a European case series. BMC Psychiatry 2016;16, 293.
Drinking "Vodka" or vodka: this is a question. Toxicol. Vitro 2016; 36, 66-70.
Repeated self-mutilation of testicles in the context of methamphetamine use: a case report and brief review of literature. J. Forensic Legal Med. 2015; 30, 1-3.
Acute intoxication due to tert-amyl alcohol: a case report. Forensic Sci. Int. 2014; 242, 31-33.
Hyperventilation with and without maintenance of isocapnia: a comparison of selected gasometric and respiratory parameters. Respir. Physiol. Neurobiol. 2014; 201, 71-74.
His current research interests include the rhabdomyolysis and novel psychoactive substances.


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