A deadly root and the science behind it: LC-HRMS and LC-MS/MS analysis in an aconite-induced suicide

Aconitine is a highly toxic alkaloid found in Aconitum species, known for their potent neurotoxic and cardiotoxic effects. While accidental poisonings are relatively rare in Europe, intentional ingestions are more frequently reported. Despite the well-documented clinical effects of aconitine, a comprehensive toxicological investigation including analysis of hair and roots responsible for poisoning has never been reported.

A fatal case of aconitine poisoning was investigated following the ingestion of Aconitum roots. Biological samples (including hair) were analyzed using liquid chromatography-tandem mass spectrometry and liquid chromatography-high-resolution mass spectometry (LC-HRMS). The roots found at the victim's residence were also examined.

Aconitine was detected in all tested biological matrices with concentrations of femoral blood and hair of 28.6 ng/mL and 54 pg/mg respectively. The amount of aconitine in the plant root was 0.6 mg/g. Based on the weight and number of roots ingested (as reported by the victim), the estimated dose of aconitine was 12 mg, approximately 2 to 4 times the known lethal dose for an adult.

This case presents the first detailed toxicological study of fatal aconitine poisoning that includes both hair and root analysis via LC-HRMS. The results highlight the value of advanced mass spectrometry in forensic detection of alkaloid exposure, while the development of a method for the identification of aconitine in hair could be useful in the future in reconstructing poisoning scenarios and assessing possible repeated exposures.