A fatal case of Taxus poisoning

Taxine-derived alkaloids, taxane-derived substances, and glycosides seem to be responsible for the toxicity of Taxus spp. by blocking microtubule, sodium and calcium channels causing conduction abnormalities. Cases with Taxus baccata acute intoxication have rarely been reported.

We report the case of a 43-year-old man who ingested, for suicidal purposes, common (or European) yew leaves (Taxus baccata) and presented severe hypokalemia, ventricular arrhythmias with hemodynamic instability accompanied by severe multiple organ dysfunction syndrome, including respiratory insufficiency, renal failure, acid-base imbalance with severe hypokalemia, hepatic dysfunction and coma, which led to death 12 hours after Taxus baccata ingestion.

In this particular case, the cardiac electrical instability was definitely maintained by several causes, including severe hypokalemia, which has not been previously reported as related to Taxus poisoning. The metabolic acidosis associated with severe hypokalemia definitely contributed to the complex arrhythmias. The occurrence of severe hypokalemia needs further attention in cases with Taxus poisoning as its immediate treatment might increase survival chances.