Department of Experimental Medicine, Forensic Toxicology Unit, University of Campania "L. Vanvitelli", Via L. Armanni, 5, 80138, Napoli, Italy.
Department Interdisciplinary of Medicine (DIM), Forensic Toxicology Laboratory, University of Bari, Piazza Giulio Cesare, 11, 70124, Bari, Italy.
Forensic Sci Med Pathol. 2021 Mar;17(1):120-125. doi: 10.1007/s12024-020-00338-w. Epub 2020 Nov 25.
An unusual case of poisoning by the ingestion of oleander leaves is reported. A 71 year old male laboratory technician committed suicide at home in this unusual manner. At the death scene a steel pan and other paraphernalia, used for the extraction of oleandrin and other cardiac glycosides from the leaves of the Nerium oleander plant were found.Toxicological investigations for oleandrin, oleandrigenin, neritaloside, and odoroside were performed by LC-MS/MS on all biological samples (peripheral blood, vitreous humor, urine, liver, gastric contents) and on the yellow infusion found at the death scene.In all samples, toxic levels of oleandrin were detected (blood 37.5 ng/mL, vitreous humor 12.6 ng/mL, urine 83.8 ng/mL, liver 205 ng/mg, gastric content 31.2 µg/mL, infusion 38.5 µg/mL). Qualitative results for oleandrigenin, neritaloside, and odoroside were obtained. Oleandrigenin was present in all tissue samples whereas neritaloside and odoroside were absent in the blood and vitreous humor but present in urine, liver, gastric content, and in the leaf brew.The purpose of this study was the identification of oleandrin and its congener oleandrigenin, detected in the vitreous humor. The blood/vitreous humor ratio was also calculated in order to assess of the likely time interval from ingestion to death. According to the toxicological results death was attributed to fatal arrhythmia due to oleander intoxication. The manner of death was classified as suicide through the ingestion of the infusion.
报告了一起罕见的因吞食夹竹桃叶而中毒的病例。一名 71 岁的男性实验室技术员以这种不寻常的方式在家中自杀。在死亡现场发现了一个钢盆和其他用具，用于从夹竹桃属植物的叶子中提取萝芙木碱和其他强心苷。通过 LC-MS/MS 对所有生物样本（外周血、玻璃体、尿液、肝脏、胃内容物）和在死亡现场发现的黄色浸液进行了萝芙木碱、萝芙木苷元、奈利塔苷和奥多苷的毒理学研究。在所有样本中均检测到有毒水平的萝芙木碱（血液 37.5ng/mL、玻璃体 12.6ng/mL、尿液 83.8ng/mL、肝脏 205ng/mg、胃内容物 31.2µg/mL、浸液 38.5µg/mL）。获得了萝芙木苷元、奈利塔苷和奥多苷的定性结果。萝芙木苷元存在于所有组织样本中，而奈利塔苷和奥多苷不存在于血液和玻璃体中，但存在于尿液、肝脏、胃内容物和叶浸液中。本研究的目的是鉴定在玻璃体中检测到的萝芙木碱及其同系物萝芙木苷元。还计算了血液/玻璃体比值，以评估从摄入到死亡的可能时间间隔。根据毒理学结果，死亡归因于夹竹桃中毒引起的致命心律失常。死亡方式被归类为通过摄入浸液自杀。
