Case report: Fatal fluoride intoxication – clinicopathological correlation and autopsy findings
DOI:
https://doi.org/10.18004/Keywords:
Fluorides, Poisoning, Autopsy, Pathology, Forensic ToxicologyAbstract
Acute fluoride intoxication is a rare but highly lethal condition, whose early diagnosis
is challenging due to the nonspecific nature of initial symptoms. We present the case of a
23-year-old Paraguayan woman, previously healthy, who ingested several compounded
capsules containing fluoride. Hours later, she developed gastrointestinal symptoms, loss of
consciousness, and cardiorespiratory arrest, dying despite resuscitation efforts. Autopsy
revealed cerebral edema, pulmonary edema with hemorrhage, gastric erosions with blood
content, and visceral congestion. Histological examination confirmed diffuse pulmonary
edema and hemorrhage, gastric foveolar erosions, and congestion of the liver, spleen, and
kidneys. Clinical laboratory findings prior to death showed severe hypocalcemia, electrolyte
disturbances, anemia, and elevated transaminases. The integration of clinical, biochemical,
and pathological findings confirmed acute fluoride intoxication as the cause of death, even in
the absence of direct serum level determination. This case highlights the irreplaceable role of
autopsy in medico-legal contexts and provides relevant evidence to support improvements in
pharmaceutical regulation and health system response to fluoride intoxications. Furthermore,
it represents a valuable contribution to the strengthening of forensic toxicology in Paraguay by
underscoring current diagnostic limitations and the need to optimize resources in this field.
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