ACutE POISOnInG WItH LIquID COnt AInInG GAmmA -ButyROLACt OnE (GBL)

Gamma-butyrolactone (GBL) is used as a solvent and cleaning agent, e.g. on chromium surfaces and to remove graffiti. After oral administration, it metabolises in the body to gamma-hydroxybutyric acid (GHB) and has a depressive effect (characteristic for this compound) on the central nervous system (CNS). This study presents a case of an acute, unintentional, oral poisoning of a 72 year old female with Pure Cleaner fluid, which contains GBL. The symptoms of poisoning developed rapidly. An unconscious, intubated woman with respiratory failure and bradycardia was admitted to the Toxicology Clinic in Krakow. Ingestion of sedative and hypnotic drugs and ethanol by the patient was ruled out by toxicological analysis. A diagnosis of poisoning was made on the basis of an interview and symptoms. Extensive toxicological analysis was performed with LC-MS. GBL was determined in the Pure Cleaner liquid that was brought to the Clinic together with the patient. The GHB concentration in the patient’s urine collected on admission to the hospital was 1550 mg/l (±201.5 mg/l).