Interpretation of hair findings in children: about a case involving carbamazepine

Drug Testing and Analysis
P Kintz

Abstract

This office has been recently involved in a case dealing with child custody, where the final outcome was difficult to establish. The following concentrations were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS) in the hair of a 21-month-old girl: 154 (0-1 cm), 198 (1-2 cm), 247 (2-3 cm), and 368 pg/mg (3-4 cm) after decontamination. Obviously, the concentrations measured in the hair were much lower than those observed in patients under daily treatment. In this sense, the frequency of exposures appears as infrequent (low level of exposure), with marked decrease in the more recent period. However, the girl was never prescribed carbamazepine and the mother, who was under carbamazepine therapy, denied any administration. The Judge asked if this could result from a single exposure and at which period. At least, three possible interpretations of the measured carbamazepine concentrations were addressed: (1) decrease in administration in the more recent period; (2) increase of body weight due to growing, so the same dosage will result in lower concentrations in hair; and (3) sweat contamination from the mother at the time the girl is with her in bed, the older hair being in contact longer with the bedding. In this...Continue Reading

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Citations

Nov 27, 2015·Forensic Science International : Synergy·Xin Wang, Olaf H Drummer
Oct 11, 2015·Journal of Forensic and Legal Medicine·Ping XiangOlaf H Drummer
Feb 14, 2015·Forensic Science International : Synergy·Nathalie AllibeFrançoise Stanke-Labesque
Dec 3, 2014·Forensic Science International : Synergy·P Kintz
Oct 19, 2017·International Journal of Legal Medicine·Jean Claude AlvarezIslam Amine Larabi
Sep 25, 2017·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Eva Cuypers, Robert J Flanagan
Jan 31, 2020·Drug Testing and Analysis·Anne-Laure Pelissier-AlicotGeorges Leonetti
Feb 10, 2021·Journal of Forensic Sciences·Pascal KintzAlice Ameline

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