Fatal aconitine intoxication or thyroid storm? A case report.
E M Arlt1, T Keller, H Wittmann
1Institute of Forensic Medicine, University of Salzburg, Austria. eva-maria.arlt@sbg.ac.at
Legal Medicine (Tokyo, Japan)
|February 21, 2012
Summary
A young woman died from lethal doses of aconitine, a potent poison found in Aconitum napellus. Her underlying thyrotoxicosis factitia and potential thyroid storm may have contributed to the fatal poisoning outcome.
Area of Science:
- Forensic Toxicology
- Endocrinology
Background:
- Aconitum napellus (wolfsbane) contains aconitine, a highly toxic alkaloid.
- Thyrotoxicosis factitia is a rare form of hyperthyroidism caused by excessive thyroid hormone intake, often for weight loss.
- Thyroid storm is a severe, life-threatening complication of hyperthyroidism.
Observation:
- A teenager was found deceased in an apartment with no signs of external trauma.
- A glass with plant remnants and liquid, later identified as Aconitum napellus, was present at the scene.
- Autopsy revealed no significant findings, but toxicology confirmed lethal levels of aconitine.
Findings:
- Lethal concentrations of aconitine were detected in all tested specimens.
- The deceased was diagnosed with thyrotoxicosis factitia, likely self-induced for weight loss.
- Aconitum napellus leaves were identified, and the liquid in the glass contained high levels of aconitine.
Implications:
- This case highlights the potential for fatal aconitine poisoning, even in non-traditional settings.
- The interaction between thyrotoxicosis factitia, potential thyroid storm, and aconitine poisoning presents a complex toxicological scenario.
- Accurate identification of plant-based toxins and underlying medical conditions is crucial in forensic investigations.
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