Publications by authors named "Irina Mikolaenko"

24 Publications

  • Page 1 of 1

CNS neutrophilic vasculitis in neuro-Sweet disease.

Neurology 2015 Sep 31;85(9):829-30. Epub 2015 Jul 31.

From NYU School of Medicine, New York.

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http://dx.doi.org/10.1212/WNL.0000000000001892DOI Listing
September 2015

Pelvic Ependymoma With Clinical Response to GnRH Analog Therapy: A Case Report With an Overview of Primary Extraneural Ependymomas.

Int J Gynecol Pathol 2015 Sep;34(5):450-8

Departments of Pathology (F.Z.) Obstretrics and Gynecology (J.S.) Neuropathology (I.M.) Gynecologic Pathology (P.S.), New York University School of Medicine Department of Pathology (M.R.), Memorial Sloan Kettering Cancer Center, New York, New York.

Extraneural ependymomas are rare tumors that occur in sacrococcygeal, pelvic and extra pelvic regions. While sacrococcygeal extraneural ependymomas are equally distributed among males and females, pelvic and extra pelvic ependymomas have been exclusively reported in women, mainly of child bearing age. We present a case of extraneural, pelvic ependymoma that showed clinical response to GnRH therapy with its immunohistochemical and electron microscopic analysis, and an overview of primary extraneural ependymomas based on a review of all such cases published in English literature.
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http://dx.doi.org/10.1097/PGP.0000000000000156DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4981882PMC
September 2015

Rare isolated trigeminal nerve sarcoidosis mimicking schwannoma.

Clin Imaging 2015 Jan-Feb;39(1):133-5. Epub 2014 Oct 16.

Department of Pathology, NYU Langone Medical Center, New York, NY, USA.

Sarcoidosis is a granulomatous disorder of unknown etiology involving multiple organ systems. Isolated neurosarcoidosis is exceedingly rare. This case report presents isolated trigeminal nerve sarcoidosis mimicking schwannoma in a patient presenting with symptoms of trigeminal neuralgia. Neuroimaging revealed a mass associated with trigeminal nerve which prospectively thought to represent schwannoma. However, surgical pathology was consistent with sarcoidosis. Given great overlap in imaging characteristic of tumors in the Meckel's cave intraoperative frozen section biopsy may be considered to rule out an inflammatory lesion.
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http://dx.doi.org/10.1016/j.clinimag.2014.08.012DOI Listing
June 2015

A case of systemic lupus erythematosus associated with longitudinal extensive transverse myelitis, cerebral neutrophilic vasculitis, and cerebritis.

Bull Hosp Jt Dis (2013) 2014 ;72(4):294-300

Systemic Lupus erythematosus (SLE) is an autoimmune disease with multiple clinical presentations and manifestations. Here, we report an intriguing case of a 30-year-old female with full-blown SLE, associated with longitudinal extensive transverse myelitis (LETM) on Magnetic Resonance Imaging (MRI) manifested by lower extremity weakness, neurogenic bladder and bowel, and central nervous system (CNS) lupus clinically manifested by changes in mood and behavior as well as neutrophilic vasculitis and cerebritis on pathology. LETM is a rare complication of SLE; however, what makes this case even more intriguing is that it additionally had cerebral lesions consistent with neutrophilic vasculitis and cerebritis, and that it may all have started at least 10 years prior with nonspecific musculoskeletal manifestations subsequently followed by a rash as well as intractable fevers of unknown etiology—much later attributed to her lupus. Although she had a most concerning and dramatic presentation, she, so far, had responded very well to therapy including pulse dose steroids, plasmapheresis, intravenous immunoglobulins (IVIG), cyclophosphamide, and related medications.
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December 2015

Multinodular and vacuolating neuronal tumors of the cerebrum: 10 cases of a distinctive seizure-associated lesion.

Brain Pathol 2013 Sep 1;23(5):515-24. Epub 2013 Feb 1.

Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.

We report 10 cases of a non-neurocytic, purely neuronal tumor affecting adults. Situated in the cerebral hemispheres, with 7 of 10 confined to the temporal lobes, most presented with seizures as their principal clinical manifestations. On magnetic resosnance imaging (MRI), the tumors generally appeared solid and non-contrast enhancing with minimal diffuse infiltration, edema, or mass effect. Six examples demonstrated internal nodularity. Microscopically, the tumor cells were largely distributed into discrete and coalescent nodules exhibiting varying degrees of matrix vacuolization, principally within the deep cortical ribbon and superficial subcortical white matter. Populating elements ranged from morphologically ambiguous to recognizably neuronal, with only two cases manifesting overt ganglion cell cytology. In all cases, tumor cells exhibited widespread nuclear immunolabeling for the HuC/HuD neuronal antigens, although expression of other neuronal markers, including synaptophysin, neurofilament and chromogranin was variable to absent. Tumor cells also failed to express GFAP, p53, IDH1 R132H, or CD34, although CD34-labeling ramified neural elements were present in the adjoining cortex of seven cases. Molecular analysis in a subset of cases failed to reveal DNA copy number abnormalities or BRAF V600E mutation. Follow-up data indicate that this unusual neuronal lesion behaves in benign, World Health Organization (WHO) grade I fashion and is amenable to surgical control.
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http://dx.doi.org/10.1111/bpa.12035DOI Listing
September 2013

Melanocytic tumor with GNA11 p.Q209L mutation mimicking a foramen magnum meningioma.

Clin Neurol Neurosurg 2012 Oct 13;114(8):1197-200. Epub 2012 Mar 13.

Department of Neurosurgery, NYU Langone Medical Center, New York, NY, United States.

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http://dx.doi.org/10.1016/j.clineuro.2012.02.030DOI Listing
October 2012

Suprasellar hamartoma and arachnoid cyst.

World Neurosurg 2013 Dec 10;80(6):e401-7. Epub 2012 Feb 10.

Neurosurgical Care, LLC, Royersford, Pennsylvania, USA. Electronic address:

Objective: The differential diagnosis for suprasellar masses includes a variety of pathologies, ranging from stable and benign lesions to aggressive and malignant ones. We report a case of a suprasellar hamartoma associated with an arachnoid cyst and review the literature surrounding the topic.

Case Description: A 32-year-old man who presented with headaches and nonspecific vision loss was found to have a cystic, calcified, and minimally contrast enhancing lesion of the suprasellar region. Intraoperative inspection revealed a discrete mass in the right side of suprasellar region that resembled normal brain completely enveloped by the basal arachnoid membranes including the membrane of Lillequist and was not connected to the brain. Fenestration and exploration of the cystic portion demonstrated a simple arachnoid cyst filled with what appeared to be cerebrospinal fluid. Given the adherence of the lesion to numerous perforating arteries arising from the posterior communicating artery, a biopsy with intraoperative confirmation was taken. Pathology was consistent with neuroglial tissue without evidence of neoplasia.

Conclusions: To our knowledge this is only the third case of an isolated suprasellar hamartoma described in the literature and the first of its kind to be associated with an arachnoid cyst.
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http://dx.doi.org/10.1016/j.wneu.2012.01.058DOI Listing
December 2013

Medulloblastoma presenting as consecutive esotropia after successful lateral rectus muscle recession for infantile exotropia.

J AAPOS 2011 Oct;15(5):499-501

Maimonides Medical Center, Brooklyn, NY, USA.

Comitant infantile exotropia is a rare entity and is far less common than infantile esotropia. It has been shown to be highly correlated with intracranial pathology. We report a case of a medulloblastoma in a child in whom it presented as an incomitant esotropia after surgical correction for comitant infantile exotropia.
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http://dx.doi.org/10.1016/j.jaapos.2011.05.018DOI Listing
October 2011

Brain metastasis of Wilms tumor with diffuse anaplasia and complex cytogenetic phenotype in a child with neurofibromatosis Type 1.

J Neurosurg Pediatr 2011 Oct;8(4):353-6

Department of Pathology, New York University, New York, New York 10016, USA.

The authors report the first case of a Wilms tumor (WT) with diffuse anaplasia metastatic to the brain in a 13-year-old girl with a history of neurofibromatosis Type 1. At presentation, the metastatic tumor had radiological features that suggested a meningioma. Histologically it was characterized by striking anaplasia and features similar to the patient's previously resected WT with diffuse anaplasia.
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http://dx.doi.org/10.3171/2011.7.PEDS1119DOI Listing
October 2011

Isolated sixth cranial nerve palsy as the presenting symptom of a rapidly expanding ACTH positive pituitary adenoma: a case report.

BMC Ophthalmol 2011 Jan 27;11. Epub 2011 Jan 27.

Department of Ophthalmology, Mount Sinai School of Medicine, New York, NY, USA.

Background: Pituitary adenoma may present with neuro-ophthalmic manifestations and, typically, rapid tumor expansion is the result of apoplexy. Herein, we present the first case of an isolated sixth cranial nerve palsy as initial feature of a rapidly expanding ACTH positive silent tumor without apoplexy.

Case Presentation: A 44 year old female with a history of sarcoidosis presented with an isolated sixth cranial nerve palsy as the initial clinical feature of a rapidly expanding ACTH positive silent pituitary adenoma. The patient underwent emergent transsphenoidal hypophysectomy for this rapidly progressive tumor and subsequently regained complete vision and ocular motility. Despite tumor extension into the cavernous sinus, the other cranial nerves were spared during the initial presentation.

Conclusions: This case illustrates the need to consider a rapidly growing pituitary tumor as a possibility when presented with a rapidly progressive ophthalmoplegia.
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http://dx.doi.org/10.1186/1471-2415-11-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3041999PMC
January 2011

A 3-year- old girl with altered mental status, gait difficulty, and vomiting.

Brain Pathol 2011 Jan;21(1):105-8

We report a case of a 3-year-old girl with a 9-month history of focal neurologic finding and signs of increased intracranial pressure. Radiological imaging studies showed a minimally heterogeneous enhancing large tumor involving left parietal region and partly filling the left lateral ventricle. Microscopically, the tumor contained prominent small true rosettes set into areas of fibrillar neuropil-like matrix. Foci of cellular tumor with extensive apoptosis were present. The neuropil-like areas and true rosettes were positive for synaptophysin immunostain. The tumor was negative for GFAP and neurofilament protein immunostains. MIB-1 proliferation index was high focally approaching 80%.
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http://dx.doi.org/10.1111/j.1750-3639.2010.00450.xDOI Listing
January 2011

Loss of cation-chloride cotransporter expression in preterm infants with white matter lesions: implications for the pathogenesis of epilepsy.

J Neuropathol Exp Neurol 2010 Jun;69(6):565-72

Divisions of Pediatric Neurosurgery, Neurology, Rainbow Babies & Children's Hospital, 11100 Euclid Ave, Cleveland, OH 44106, USA.

Epilepsy associated with preterm birth is often refractory to anticonvulsants. Children who are born preterm are also prone to cognitive delay and behavioral problems. Brains from these children often show diffuse abnormalities in cerebral circuitry that is likely caused by disrupted development during critical stages of cortical formation. To test the hypothesis that prenatal injury impairs the developmental switch of gamma-amino butyric acid (GABA)ergic synapses from excitatory to inhibitory, thereby disrupting cortical circuit formation and predisposing to epilepsy, we used immunohistochemistry to compare the expression of cation-chloride transporters that developmentally regulate postsynaptic GABAergic discharges in postmortem cerebral samples from infants born preterm with known white matter injury (n = 11) with that of controls with minimal white matter gliosis (n = 7). Controls showed the expected developmental expression of cation-chloride transporters NKCC1 and KCC2 and ofcalretinin, a marker of a GABAergic neuronal subpopulation. Samples from infants with white matter damage showed a significant loss of expression of both NKCC1 and KCC2 in subplate and white matter. By contrast, there were no significant differences in total cell number or glutamate transporter VGLUT1 expression. Together, these novel findings suggest a molecular mechanism involved in the disruption of a critical stage of cerebral circuit development after brain injury from preterm birth that may predispose to epilepsy.
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http://dx.doi.org/10.1097/NEN.0b013e3181dd25bcDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3165026PMC
June 2010

Metameric thoracic lesion: report of a rare case and a guide to management.

J Neurosurg Spine 2010 May;12(5):497-502

Department of Neurosurgery, NYU Langone Medical Center, Bellevue Hospital, New York, New York 10016, USA.

Metameric lesions of the spine are rare. The authors present a case of patient with a complex metameric vascular lesion of the thoracic spine and describe a management strategy for this entity.
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http://dx.doi.org/10.3171/2009.11.SPINE09259DOI Listing
May 2010

Cystic choroid plexus papilloma in the cavum septum pellucidum.

J Neurosurg Pediatr 2009 Dec;4(6):580-3

Department of Neurosurgery, New York University Langone Medical Center, New York, New York, USA.

A choroid plexus papilloma is a rare CNS neoplasm arising from the neuroepithelial lining of the choroid plexus. A third ventricular location of a choroid plexus papilloma is rare compared with the more common sites in the lateral and fourth ventricles. Cystic choroid plexus papilloma represents an infrequent subtype that may present diagnostic ambiguity. The authors present a case of cystic choroid plexus papilloma within a cavum septum pellucidum that radiographically mimicked neurocysticercosis.
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http://dx.doi.org/10.3171/2009.7.PEDS08484DOI Listing
December 2009

Systemic CD5+ MALT lymphoma: presentation with Waldenstrom syndrome.

Ann Diagn Pathol 2009 Aug 7;13(4):272-7. Epub 2008 Jul 7.

Department of Pathology, Case Western Reserve University, Pathology Institute, Cleveland, OH 44106, USA.

We report a case of extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) in a 75-year-old woman with a neuropathy related to high levels of serum immunoglobulin M and a history of rheumatoid arthritis and polymyositis. The patient developed a mass in the right submandibular salivary gland, and this mass demonstrated histopathologic features that are typical of MALT lymphoma, including infiltrates of small monocytoid B cells in the epithelium (forming "lymphoepithelial lesions"), a reactive background of florid germinal center hyperplasia, and follicular colonization by the monocytoid B cells. Many plasma cells in the background expressed cytoplasmic immunoglobulin M lambda, matching the serum spike. Flow cytometric analysis confirmed the presence of clonal mature B cells; however, unlike most MALT lymphomas, these cells coexpressed dim CD5. Clinical staging revealed evidence of systemic distribution with documented disease involving the bone marrow, the lung, and a paratracheal lymph node. Analysis of this unusual systemic MALT lymphoma, and a comparison with similar examples from the literature, illuminates relationships among MALT lymphoma, chronic lymphocytic leukemia/small lymphocytic lymphoma, and Waldenstrom macroglobulinemia.
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http://dx.doi.org/10.1016/j.anndiagpath.2008.04.010DOI Listing
August 2009

Diagnostic quality of: polyps resected by snare polypectomy: does the type of electrosurgical current used matter?

Am J Gastroenterol 2006 Sep 18;101(9):2123-7. Epub 2006 Jul 18.

Department of Medicine, Division of Gastroenterology and Hepatology, VA Medical Center Hospital and University of Alabama Hospital, University of Alabama, Birmingham, Alabama, USA.

Background: Traditionally, snare polypectomy is performed using blended, coagulation, or pure cutting electrical current (EC). The aim of this study was to assess and compare the diagnostic quality of polyps obtained by snare polypectomy using two different electrosurgical currents.

Methods: Consecutive patients undergoing colonoscopy underwent polypectomy using either blended EC with a conventional electrosurgical generator (ESG) or using an ESG with a microprocessor that automatically controls cutting and coagulation (Endocut). An experienced blinded gastrointestinal (GI) pathologist evaluated the specimens for diameter, cautery damage (amount and degree), margin evaluability, architecture, and general histologic diagnostic quality.

Results: One hundred sixteen patients (69% men, mean age 63.8 +/- 15 yr) underwent 148 polypectomies (78 using blended current and 70 using Endocut). We found that the cautery degree was less with the Endocut than with the blended current (p < 0.02). Cautery amount was also higher in polyps resected using blended current (56%) than Endocut (51%) but this difference did not reach statistical significance (p= 0.1). Polyps resected using Endocut had better margin evaluability (75.7% to 60.3%, p= 0.046). The overall tissue architecture was similar in both groups. Polyps removed with blended current had less overall quality as compared to polyps removed by Endocut (p= 0.024).

Conclusions: More extensive tissue damage occurred using blended EC with the conventional ESG than when using Endocut. The quality of the polypectomy specimens was overall better using Endocut. Finally, the ability to evaluate resected polyp margins and overall tissue histology was better with the microprocessor-controlled ESG than with the conventional ESG.
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http://dx.doi.org/10.1111/j.1572-0241.2006.00696.xDOI Listing
September 2006

A 50-year-old man with acute-onset generalized seizure. Cerebral amyloid angiopathy and associated giant cell reaction.

Arch Pathol Lab Med 2006 Jan;130(1):e5-7

Department of Neurology, The Johns Hopkins School of Medicine, Baltimore, MD, USA.

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http://dx.doi.org/10.1043/1543-2165(2006)130[e5:AYMWAG]2.0.CO;2DOI Listing
January 2006

Expression of Notch-1 and its ligands, Delta-like-1 and Jagged-1, is critical for glioma cell survival and proliferation.

Cancer Res 2005 Mar;65(6):2353-63

Neuro-Oncology Branch, National Cancer Institute, NIH, Bethesda, MD 20892, USA.

The Notch family of proteins plays an integral role in determining cell fates, such as proliferation, differentiation, and apoptosis. We show that Notch-1 and its ligands, Delta-like-1 and Jagged-1, are overexpressed in many glioma cell lines and primary human gliomas. Immunohistochemistry of a primary human glioma tissue array shows the presence in the nucleus of the Notch-1 intracellular domain, indicating Notch-1 activation in situ. Down-regulation of Notch-1, Delta-like-1, or Jagged-1 by RNA interference induces apoptosis and inhibits proliferation in multiple glioma cell lines. In addition, pretreatment of glioma cells with Notch-1 or Delta-like-1 small interfering RNA significantly prolongs survival in a murine orthotopic brain tumor model. These results show, for the first time, the dependence of cancer cells on a single Notch ligand; they also suggest a potential Notch juxtacrine/autocrine loop in gliomas. Notch-1 and its ligands may present novel therapeutic targets in the treatment of glioma.
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http://dx.doi.org/10.1158/0008-5472.CAN-04-1890DOI Listing
March 2005

Alpha-synuclein lesions in normal aging, Parkinson disease, and Alzheimer disease: evidence from the Baltimore Longitudinal Study of Aging (BLSA).

J Neuropathol Exp Neurol 2005 Feb;64(2):156-62

Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205-2196, USA.

Alpha-synuclein (alpha-synuclein) lesions are characteristic of idiopathic Parkinson disease (PD) and other alpha-synucleinopathies. To study the frequency of alpha-synuclein lesions in normal aging and how frequently they coexist with lesions of Alzheimer disease (AD), we examined the autopsy brains from normal and demented subjects in the Baltimore Longitudinal Study of Aging (BLSA) (n = 117). We found that the overall frequency of alpha-synuclein lesions was 25%, with 100% in 7 cases of PD, 31.5% in 56 cases with AD lesions, and 8.3% among 36 older control brains. Among brains with AD lesions, the frequency of alpha-synuclein pathology was higher in those with higher scores for neuritic plaques, but not in those with higher scores for neurofibrillary tangles. Our observations indicate that alpha-synuclein lesions are uncommon in aged control subjects. Finally, the coexistence of Abeta amyloid and alpha-synuclein pathology in AD brains suggests that the pathogenic mechanism/s leading to the accumulation of Abeta and alpha-synuclein may be similar.
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http://dx.doi.org/10.1093/jnen/64.2.156DOI Listing
February 2005

Notch1 and notch2 have opposite effects on embryonal brain tumor growth.

Cancer Res 2004 Nov;64(21):7787-93

Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.

The role of Notch signaling in tumorigenesis can vary; Notch1 acts as an oncogene in some neoplasms, and a tumor suppressor in others. Here, we show that different Notch receptors can have opposite effects in a single tumor type. Expression of truncated, constitutively active Notch1 or Notch2 in embryonal brain tumor cell lines caused antagonistic effects on tumor growth. Cell proliferation, soft agar colony formation, and xenograft growth were all promoted by Notch2 and inhibited by Notch1. We also found that Notch2 receptor transcripts are highly expressed in progenitor cell-derived brain tumors such as medulloblastomas, whereas Notch1 is scarce or undetectable. This parallels normal cerebellar development, during which Notch2 is predominantly expressed in proliferating progenitors and Notch1 in postmitotic differentiating cells. Given the oncogenic effects of Notch2, we analyzed its gene dosage in 40 embryonal brain tumors, detecting an increased copy number in 15% of cases. Notch2 gene amplification was confirmed by fluorescence in situ hybridization in one case with extremely high Notch2 mRNA levels. In addition, expression of the Notch pathway target gene Hes1 in medulloblastomas was associated with significantly shorter patient survival (P = 0.01). Finally, pharmacological inhibition of Notch signaling suppresses growth of medulloblastoma cells. Our data indicate that Notch1 and Notch2 can have opposite effects on the growth of a single tumor type, and show that Notch2 can be overexpressed after gene amplification in human tumors.
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http://dx.doi.org/10.1158/0008-5472.CAN-04-1446DOI Listing
November 2004

Rhabdoid meningioma: cytopathologic findings in cerebrospinal fluid.

Diagn Cytopathol 2003 Nov;29(5):297-9

Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland 21287, USA.

Rhabdoid meningioma is a recently described, rare, WHO Grade III intracranial tumor with an aggressive growth pattern and increased risk of recurrence. We describe the cytopathologic findings on cerebrospinal fluid of one such case in a 26-yr-old female who underwent resection of a left temporo-parietal mass. Cerebrospinal fluid contained abundant malignant cells with a prominent "rhabdoid" phenotype, i.e., large cells, eccentric nuclei, single prominent nucleoli, and dense eosinophilic cytoplasm. Although rhabdoid meningioma has a characteristic cytomorphology, the differential diagnosis of this tumor would involve metastatic adenocarcinoma, metastatic malignant melanoma, and other tumors with "rhabdoid" features (such as an atypical teratoid/rhabdoid tumor).
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http://dx.doi.org/10.1002/dc.10374DOI Listing
November 2003

A review of methadone deaths in Jefferson County, Alabama.

Am J Forensic Med Pathol 2002 Sep;23(3):299-304

Department of Pathology, University of Alabama at Birmingham, 35233-1601, USA.

Interpretation of the concentration of a drug is more difficult when a combination of drugs is present in a decedent's blood. An increase in deaths resulting from co-intoxication with methadone and a benzodiazepine led the authors to perform a retrospective study of cases examined at the Jefferson County Coroner/Medical Examiner Office. They found 101 deaths wherein methadone was detected in the blood. Based on the drugs detected in the blood, these 101 cases were grouped into four categories: (1) pure methadone intoxication, (2) intoxication with methadone and benzodiazepine, (3) intoxication with methadone and other drugs excluding benzodiazepine, and (4) intoxication with methadone, benzodiazepines, and other drugs. Methadone was the sole intoxicant in 15 cases, with a mean concentration of 0.27 mg/L. Benzodiazepines were the most frequently detected co-intoxicant (60 of 101 cases). Benzodiazepine was the only co-intoxicant in 30 cases, and the mean methadone concentration in those 30 cases was 0.599 mg/L. Higher levels of methadone may occur in acute intoxication with methadone and benzodiazepine because benzodiazepines compete with methadone for methadone receptors. Higher levels of methadone may occur with chronic abuse of methadone and benzodiazepines because over time, benzodiazepines inhibit the hepatic enzymes that metabolize methadone.
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http://dx.doi.org/10.1097/00000433-200209000-00021DOI Listing
September 2002

Pathologic quiz case: a 35-year old woman with a history of arrhythmia and liver failure.

Arch Pathol Lab Med 2002 Jun;126(6):751-2

Department of Pathology, Division of Anatomic Pathology, University of Alabama at Birmingham, 35233-6823, USA.

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http://dx.doi.org/10.1043/0003-9985(2002)126<0751:PQCAYO>2.0.CO;2DOI Listing
June 2002