title: A suicide attempt by intoxication with Taxus baccata leaves and ultra-fast liquid chromatography-electrospray ionization-tandem mass spectrometry, analysis of patient serum and different plant samples: case report.
abstract: Taxus (yew) is one of the most frequently reported plants causing potentially fatal outcome when taken incidentally or for suicidal reasons. A fast and reliable method of detection of poisonous compounds or their metabolites is critical in life-saving procedures in cases of yew ingestion. Previously, several chromatographic analytical procedures have been described usually taking longer than one hour of total analysis time.
  
  
  
  In this report we describe a suicide case study and an ad hoc developed fast method of detection and quantitation of 3,5-dimethoxyphenol - the main taxane metabolite in the blood plasma from the patient as well as the determination of major taxine components in the plant material (Taxus baccata). At present, there is no reasonable alternative for mass spectrometry that could match its high sensitivity and accuracy, and Multiple Reaction Monitoring could be adequate and useful mass spectrometry technique in analyzing and identification of plants material compounds that cause severe poisoning in humans. In the reported case, intensive cardiac care together with the astuteness of the treating physicians not only saved the patient's life, but also allowed for his complete recovery and return to work.
  
  
  
  The development of ultra fast liquid chromatography tandem mass spectrometry UFLC-MS/MS method provides a fast means to confirm yew alkaloids and their metabolite in various material. The applied analytical procedure allows early detection of main metabolite in patient material as well as comparing to those extracted from the plant. In our study, the taxanes remained undetected, probably due to the time elapsing from the patient admittance and collection of plasma. In cases like those reported in this study, retaining the gastric material should be obligatory to confirm the ingestion of yew. The possibility of using this approach in detection of native taxine compounds in human plasma remains to be verified.
authors: Department of Cardiology, Medical University of Wroclaw, ul. Borowska 213, Wroclaw, 50-556, Poland. kobusiak@poczta.fm.
authors: Małgorzata
authors: M
authors: Kobusiak-Prokopowicz
authors: Department of Cardiology, Medical University of Wroclaw, ul. Borowska 213, Wroclaw, 50-556, Poland.
authors: Anna
authors: A
authors: Marciniak
authors: Department of Pharmaceutical Biology and Botany, Medical University of Wroclaw, Wroclaw, Poland.|Department of Biochemistry, IUNG Institute of Plant Cultivation and Soil Science, Pulawy, Poland.
authors: Sylwester
authors: S
authors: Ślusarczyk
authors: Department of Cardiology, Medical University of Wroclaw, ul. Borowska 213, Wroclaw, 50-556, Poland.
authors: Krzysztof
authors: K
authors: Ściborski
authors: Department of Cardiology, Medical University of Wroclaw, ul. Borowska 213, Wroclaw, 50-556, Poland.
authors: Aneta
authors: A
authors: Stachurska
authors: Department of Cardiology, Medical University of Wroclaw, ul. Borowska 213, Wroclaw, 50-556, Poland.
authors: Andrzej
authors: A
authors: Mysiak
authors: Department of Pharmaceutical Biology and Botany, Medical University of Wroclaw, Wroclaw, Poland.
authors: Adam
authors: A
authors: Matkowski
mesh_terms: D002851:Chromatography, High Pressure Liquid / Q000379:methods; D004562:Electrocardiography / Q000187:drug effects / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D010936:Plant Extracts / Q000097:blood / Q000633:toxicity*; D018515:Plant Leaves / Q000737:chemistry / Q000378:metabolism / Q000633:toxicity*; D021241:Spectrometry, Mass, Electrospray Ionization / Q000379:methods*; D013406:Suicide, Attempted / Q000523:psychology; D053719:Tandem Mass Spectrometry / Q000379:methods*; D020946:Taxus / Q000737:chemistry / Q000378:metabolism / Q000633:toxicity*
chemical_list: D010936:Plant Extracts
keywords: Acute heart failure; Liquid chromatography; Mass spectrometry; Taxus; Yew alkaloids