A fatal case of aconite poisoning: accidental intake of a monkshood extract

摘要

Purpose Monkshood is a wild growing plant which contains the very toxic alkaloid aconitine, and is often used in traditional Chinese medicine. In this case report, we describe a fatal accident after the unintentional consumption of an aconite extract. Method By applying high-performance liquid chromatography-tandem mass spectrometry, the distribution of the alkaloid aconitine in body fluids and organ tissues has been determined, as well as the concentration of the extract taken from the confiscated bottle. Results The concentration of aconitine in peripheral blood of the deceased was 19 ng/mL; the highest concentration in organ tissue was found in the liver specimen, which revealed a content of 205 ng/g, followed by the kidneys, lungs, muscle and the brain. Moreover, aconitine contents of the blossoms, roots and leaves of a wild growing monkshood were determined. The plant extract itself showed a high concentration (628 mg/L) of the alkaloid. Conclusion The present case report emphasizes the danger of aconite extracts and presents results of the distribution of the alkaloid in the human body.