title: A case of aconitine poisoning with analysis of aconitine alkaloids by GC/SIM.
abstract: Described here is a fatal case of accidental aconitine poisoning following the ingestion of aconite, Torikabuto, mistaken for an edible grass, Momijigasa. A 61-year-old man developed symptoms of nausea, diarrhea, and discomfort of the body about 2 h after the ingestion and was taken to an emergency room. Resuscitation and antiarrhythmic drugs were ineffective, and ventricular tachycardia and fibrillation developed and lasted for 6 h. He was transferred to a coronary care unit and complete sinus rhythm was obtained on an electrocardiogram 30 h after his admission. The patient fell into a coma and died of brain edema diagnosed by CT on the 6th day. Consent for autopsy was denied by the family but was given for gas chromatography/selected ion monitoring (GC/SIM) to analyze the toxicity of aconitine alkaloids in the blood and the urine. Only a faint amount of jesaconitine was detected, while aconitine, mesaconitine and hypaconitine were not detectable in the blood 24 h after ingestion. On the other hand, aconitine and its related alkaloids such as mesaconitine, jesaconitine, and hypaconitine were clearly detected in the urine.
authors.affiliation: Department of Forensic Medicine, Akita University School of Medicine, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Yoshioka
authors.forename: K
authors.initials: K
authors.lastname: Gonmori
authors.forename: A
authors.initials: A
authors.lastname: Tagashira
authors.forename: O
authors.initials: O
authors.lastname: Boonhooi
authors.forename: M
authors.initials: M
authors.lastname: Hayashi
authors.forename: Y
authors.initials: Y
authors.lastname: Saito
authors.forename: M
authors.initials: M
authors.lastname: Mizugaki
mesh_terms: D000157:Aconitine / Q000031:analogs & derivatives / Q000506:poisoning* / Q000652:urine; D002849:Chromatography, Gas / Q000379:methods*; D017809:Fatal Outcome; D005554:Forensic Medicine; D006801:Humans; D017736:Ion-Selective Electrodes; D008297:Male; D008875:Middle Aged; D010945:Plants, Edible; D006109:Poaceae; D011041:Poisoning / Q000097:blood / Q000652:urine
chemical_list: C058309:hypaconitine; C019470:mesaconitine; C069418:jesaconitine; D000157:Aconitine