title: Fatal Taxus baccata ingestion with perimortem serum taxine B quantification.
abstract: BACKGROUND
  Common yew (Taxus baccata) is a common decorative evergreen shrub with potentially fatal toxicity hallmarked by seizure, arrhythmia and cardiovascular collapse if ingested. Taxine B has been identified as one of the most cardiotoxic taxine alkaloids in Taxus spp, and another alkaloid, 3,5-dimethoxyphenol (3,5-DMP), is used as a marker of ingestion. We present a fatal case of ingestion of yew with perimortem serum and gastric taxine B, and 3,5-DMP concentrations.
  
  
  METHODS
  A 22-year-old woman was brought to the emergency department (ED) from a nearby botanical garden after she was found apneic and pulseless after a witnessed generalized tonic clonic seizure. The patient was found to have a wide complex rhythm with persistent cardiovascular collapse and expired despite maximal supportive care in the ED. A baggie of plant material was found on the patient, identified as Taxus baccata. Perimortem serum and gastric samples were analyzed to quantify serum and gastric taxine B and 3,5-DMP concentrations.
  
  
  RESULTS
  Perimortem serum showed a 3,5-DMP concentration of 86.9 ng/mL, and taxine B of 80.9 ug/mL.
  
  
  CONCLUSIONS
  We report a perimortem serum and gastric taxine B and 3,5-DMP concentrations in a fatal case of T. baccata toxicity.
authors.affiliation: a Department of Emergency Medicine , University of California , San Francisco , CA , USA.|b San Francisco Division , California Poison Control System , San Francisco , CA , USA.
authors.forename: Ann M
authors.initials: AM
authors.lastname: Arens
authors.affiliation: c Department of Emergency Medicine , Alameda Health System/Highland Hospital , Oakland , CA , USA.
authors.forename: Tiffany C
authors.initials: TC
authors.lastname: Anaebere
authors.affiliation: d Department of Laboratory Medicine , University of California , San Francisco , CA , USA.
authors.forename: Howard
authors.initials: H
authors.lastname: Horng
authors.affiliation: b San Francisco Division , California Poison Control System , San Francisco , CA , USA.|e Department of Medicine , University of California , San Francisco , CA , USA.
authors.forename: Kent
authors.initials: K
authors.lastname: Olson
mesh_terms: D000470:Alkaloids / Q000097:blood* / Q000378:metabolism; D004636:Emergency Service, Hospital; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D010696:Phloroglucinol / Q000031:analogs & derivatives* / Q000097:blood / Q000378:metabolism; D010939:Plant Poisoning / Q000503:physiopathology*; D012640:Seizures / Q000209:etiology; D043823:Taxoids / Q000097:blood* / Q000378:metabolism; D020946:Taxus / Q000506:poisoning*; D055815:Young Adult
chemical_list: D000470:Alkaloids; D043823:Taxoids; C047703:taxine; C015155:phloroglucinol dimethyl ether; D010696:Phloroglucinol
keywords: Taxus baccata; common yew; heart; taxine B