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Confirmation of oleander poisoning by HPLC/MS
A Tracqui1, P Kintz, F Branche
1Institut de Médecine Légale, Faculte de Medecine, Strasbourg, France.
International Journal of Legal Medicine
|February 11, 1998
Summary
This case study details a non-fatal Nerium oleander poisoning. Mass spectrometric identification of oleandrin in blood confirmed the diagnosis, highlighting HPLC/MS as a key forensic toxicology tool.
Area of Science:
- Toxicology
- Analytical Chemistry
Background:
- Cardiac glycoside poisoning can be life-threatening.
- Nerium oleander contains oleandrin, a potent cardiac glycoside.
Observation:
- A 45-year-old female presented with symptoms including nausea, vomiting, abdominal pain, phosphenes, cardiovascular shock, and sinus bradycardia after self-poisoning with Nerium oleander.
- Initial assessment revealed significant cardiac and gastrointestinal distress.
Findings:
- Blood and urine samples were analyzed for oleandrin using high-performance liquid chromatography/mass spectrometry (HPLC/MS).
- Oleandrin was detected in the patient's blood at a concentration of 1.1 ng/ml upon admission.
- This marks the first documented instance of oleander intoxication confirmed by mass spectrometric identification of oleandrin in blood.
Implications:
- HPLC/MS is a highly specific and effective method for identifying oleandrin.
- This technique is recommended for forensic-toxicological investigations of cardiac glycoside poisonings.
- Accurate identification aids in timely and appropriate patient management.