Paramethoxyamphetamine (PMA) : related fatalities in Antwerp, Belgium
Faculty of Pharmaceutical, Biomedical and Veterinary Sciences. Pharmacy
Faculty of Medicine and Health Sciences
Bologna :Medimond, 2002
16th Meeting of the International Association of Forensic Sciences, September 2-7, 2002, Montpellier, France
University of Antwerp
During the Summer of 2001, 4 drug-related fatalities were encountered over a period of a few weeks in the Antwerp area, supposedly XTC-related deaths but in which toxicology revealed the presence of the designer drug paramethoxyamphetamine (PMA). In 2 cases, recorded clinical symptomatology was available: previous visit of a dance scene, alleged intake of XTC, aggressive behaviour, fever (> 40degrees C), profuse sweating, spastic movements, muscle cramps and sudden collapse. Postmortem findings were non-specific: facial cyanosis, mydriasis, oedema and congestion of lungs and brain, haemorrhagic gastritis and acute tubulus necrosis. Toxicology revealed levels of PMA ranging between 1.7 and 3.4 mug/ml in blood and between 3.4 and 10.7 mug/g in liver tissue. The pathophysiology of these deaths results from hyperpyrexia, rhabdomyolysis (acute tubular necrosis, hyperpotassaemia) and ventricular arrhythmia. This small lethal 'outbreak' of PMA-related fatalities was probably the result of a legal loophole since the precursor molecule (paramethoxy-phenylacetone) was at the time of these fatalities not a regulated substance in Belgium.