title: Two cases of lysergamide intoxication by ingestion of seeds from Hawaiian Baby Woodrose.
abstract: We describe two cases of human consumption of seeds from Argyreia nervosa (Hawaiian Baby Woodrose), which resulted in one fatality due to falling from a building and one surviving witness. The principal psychoactive constituent of the seeds, lysergamide (LSA), was recovered from blood and urine samples by mixed-mode cation exchange solid-phase extraction and quantified by ultra performance liquid chromatography-time of flight mass spectrometry (UPLC-ToF/MS). The LSA concentrations were determined by UPLC-ToF/MS to be 4.9 microg/L in blood and 1.0mg/L in urine in the dead person and 1.8 microg/L in blood and 0.50mg/L in urine in the living person. These analytical findings were found to be in accordance with the case story, which indicated that seeds had been ingested and also noted psychological reactions, i.e. the will to jump out of the window. Other findings in the dead person were 22 microg/L THC in blood, 0.71 g/L ethanol in blood and 1.0 g/L ethanol in vitreous humor. Constituents originating from the seeds of A. nervosa, i.e. LSA, ergonovine, lysergic acid alpha-hydroxyethylamide were also identified in the biological samples. The 2-hydroxy-3-oxo metabolites of LSA and ergonovine were identified in the urine sample of the deceased.
authors.affiliation: Department of Forensic Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark. helene.klinke@forensic.ku.dk
authors.forename: Helene Bendstrup
authors.initials: HB
authors.lastname: Klinke
authors.forename: Irene Breum
authors.initials: IB
authors.lastname: Müller
authors.forename: Steffen
authors.initials: S
authors.lastname: Steffenrud
authors.forename: Rasmus
authors.initials: R
authors.lastname: Dahl-Sørensen
mesh_terms: D000058:Accidental Falls; D000328:Adult; D002492:Central Nervous System Depressants / Q000032:analysis; D002851:Chromatography, High Pressure Liquid; D013759:Dronabinol / Q000097:blood; D000431:Ethanol / Q000032:analysis; D053593:Forensic Toxicology; D006207:Half-Life; D006213:Hallucinogens / Q000009:adverse effects* / Q000097:blood / Q000652:urine; D006801:Humans; D008238:Lysergic Acid Diethylamide / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000097:blood / Q000652:urine; D008297:Male; D008385:Marijuana Smoking / Q000009:adverse effects; D013058:Mass Spectrometry; D009104:Multiple Trauma / Q000473:pathology; D011605:Psychoses, Substance-Induced / Q000209:etiology*; D012639:Seeds / Q000009:adverse effects*; D052616:Solid Phase Extraction; D014822:Vitreous Body / Q000737:chemistry
chemical_list: D002492:Central Nervous System Depressants; D006213:Hallucinogens; C016543:lysergamide; D000431:Ethanol; D013759:Dronabinol; D008238:Lysergic Acid Diethylamide