A fatal case of mexiletine intoxication in a 25-year-old Korean man

摘要: Mexiletine is a well-known class IB antiarrhythmic agent that primarily used for the treatment of ventricular arrhythmias. As major route metabolism, mexiletine hydroxylated by cytochrome P450 2D6 (CYP2D6), forming metabolites, which have no significant activity. However, few cases overdose with genetic polymorphism been reported in literature. We report fatal intoxication case 25-year-old Korean male. After toxicological screening, was initially identified gas chromatography–mass spectrometry and subsequently confirmed ultrahigh-performance liquid chromatography–tandem mass spectrometry. The results described levels femoral heart blood as 14.3 (range 13.6–14.6) 22.4 21.5–23.8) ng/mL, respectively. Clopidogrel below limit quantification (< 0.002 ng/mL) from blood. Eight alleles were genotyped within CYP2D6, most frequently mutated gene East Asians, including Koreans. mutant CYP2D6 observed case. current result determined to be young man homozygous wild allele. A genotyping may predict dose individuals.