Reflections on the aconitine poisoning.
Yang Ya1, Zhang Zhixiang1, Liu Chao1
1Department of Forensic Medicine, Soochow University, Ganjiang East Road, Suzhou, 215000, China.
Journal of Forensic Sciences
|July 8, 2021
Summary
Accidental aconitine poisoning caused a fatal outcome in a 65-year-old man despite traditional Chinese medicine use. Liquid chromatography-tandem mass spectrometry confirmed aconitine toxicity, highlighting the need for regulation.
Area of Science:
- Toxicology
- Pharmacology
- Herbal Medicine
Background:
- Aconitine, a potent alkaloid from Aconitum species, is used in traditional Chinese medicine.
- Acute poisoning cases underscore the narrow therapeutic window and inherent risks of aconitine.
Observation:
- A 65-year-old man presented with symptoms including fever and pain, rapidly deteriorating after consuming Chinese medicinal wine.
- Clinical presentation included severe neurological, cardiovascular, and gastrointestinal symptoms, leading to death on the same day.
Findings:
- Postmortem examination revealed organ congestion and inflammation.
- Liquid chromatography-tandem mass spectrometry (LC-MS/MS) confirmed lethal levels of aconitine in blood, stomach contents, and the medicinal wine.
Implications:
- This case highlights the critical danger of acute aconitine poisoning from contaminated or improperly prepared traditional remedies.
- The study emphasizes the need for stringent government control over aconitine-containing herbal products and improved public awareness.
- LC-MS/MS is validated as a rapid, sensitive, and accurate method for detecting and quantifying aconitine in forensic toxicology.
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