A 59-year-old male was found dead at home, with two empty vials of an oily preparation obtained from a manufacturer from East Europe. There was no label on the vial. The subject was a former weightlifter, also known as an anabolic steroids abuser. The local prosecutor ordered a body examination, which was unremarkable, and allowed collecting femoral blood, urine and scalp hair (6 cm, brown). He was treated for cardiac insufficiency with quinidine. Biological specimens were submitted not only to standard toxicological analyses including a screening with liquid chromatography (LC)–quadrupole time of flight, but also to a specific LC–tandem mass spectrometry method for anabolic steroids testing. Ethanol was not found in both blood and urine. Quinidine blood concentration (791 ng/mL) was therapeutic. No drug of abuse was identified. In blood, testosterone was less that 1 ng/mL and no other steroid was identified. In urine, testosterone/epitestosterone was 1.56 and boldenone was present at a concentration of 9 ng/mL. The hair test results, performed on the whole length, demonstrated repetitive steroids abuse, including not only testosterone (140 pg/mg), testosterone propionate (605 pg/mg) and testosterone decanoate (249 pg/mg), but also boldenone (160 pg/mg), trenbolone (143 pg/mg) and metandienone (60 pg/mg). Since forensic laboratories have limited access to steroid urinary metabolite reference material due to specific regulations (to avoid testing athletes before anti-doping verifications), hair analyses seem to be the best approach to document anabolic agents abuse. Indeed, in hair, the target drug is the parent compound; in addition, when compared to blood or urine, this matrix has a much larger window of detection. The pathologist concluded cardiac insufficiency in a context involving repetitive abuse of anabolic drugs. This case indicates that more attention should be paid to anabolic steroids, in a context of sudden cardiac death.

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在涉及类固醇的死亡案例中，头发检测比血液或尿液检测提供更多信息

一名 59 岁的男性被发现在家中死亡，其中有两个空瓶，里面装有从东欧一家制造商那里获得的油性制剂。小瓶上没有标签。受试者是一名前举重运动员，也被称为合成代谢类固醇滥用者。当地检察官下令进行身体检查，检查并无异常，并允许采集股血、尿液和头皮毛发（6 厘米，棕色）。他因心功能不全而接受奎尼丁治疗。生物标本不仅要进行标准毒理学分析，包括液相色谱 (LC)-四极杆飞行时间筛选，还要接受特定的 LC-串联质谱法进行合成代谢类固醇测试。血液和尿液中均未发现乙醇。奎尼丁血浓度 (791 ng/mL) 是治疗性的。没有发现滥用药物。在血液中，睾酮低于 1 ng/mL，没有发现其他类固醇。在尿液中，睾酮/表睾酮为 1.56，而宝丹酮的浓度为 9 ng/mL。对整个长度进行的头发测试结果表明，重复滥用类固醇，不仅包括睾酮 (140 pg/mg)、丙酸睾酮 (605 pg/mg) 和癸酸睾酮 (249 pg/mg)，还包括宝丹酮 (160 pg/mg)、群勃龙 (143 pg/mg) 和metandienone (60 pg/mg)。由于特定法规（为了避免在反兴奋剂验证之前对运动员进行测试），法医实验室对类固醇尿液代谢物参考材料的访问有限，因此头发分析似乎是记录合成代谢剂滥用的最佳方法。事实上，在头发中，目标药物是母体化合物。此外，与血液或尿液相比，这个矩阵有一个更大的检测窗口。病理学家在涉及重复滥用合成代谢药物的情况下得出了心脏功能不全的结论。这个案例表明，在心源性猝死的情况下，应该更多地关注合成代谢类固醇。