Severe clinical toxicity caused by 25I-NBOMe confirmed analytically using LC-MS-MS method

Rhabdomyolysis is a relatively rare, but potentially serious complication of various diseases. Muscular injury and resultant release of electrolytes, myoglobin and other enzymatic proteins e.g. creatine kinase (CK) into circulation may result in multi-organ failure requiring an extensive treatment. Non-traumatic causes of rhabdomyolysis, like poisonings, appear to be much more frequent than traumatic causes. We present the case of a patient who developed exceptionally massive rhabdomyolysis, with CK up to 516 455 U/l, after ingestion of a relatively small dose of a novel psychoactive substance known as "Alice in Wonderland". Laboratory quantification was performed using a validated LC-MS/MS method in a whole blood sample.