Yoshioka N, Gonmori K, Tagashira A, Boonhooi O, Hayashi M, Saito Y, Mizugaki M
Department of Forensic Medicine, Akita University School of Medicine, Japan.
Forensic Sci Int. 1996 Aug 15;81(2-3):117-23. doi: 10.1016/s0379-0738(96)01980-9.
Described here is a fatal case of accidental aconitine poisoning following the ingestion of aconite, Torikabuto, mistaken for an edible grass, Momijigasa. A 61-year-old man developed symptoms of nausea, diarrhea, and discomfort of the body about 2 h after the ingestion and was taken to an emergency room. Resuscitation and antiarrhythmic drugs were ineffective, and ventricular tachycardia and fibrillation developed and lasted for 6 h. He was transferred to a coronary care unit and complete sinus rhythm was obtained on an electrocardiogram 30 h after his admission. The patient fell into a coma and died of brain edema diagnosed by CT on the 6th day. Consent for autopsy was denied by the family but was given for gas chromatography/selected ion monitoring (GC/SIM) to analyze the toxicity of aconitine alkaloids in the blood and the urine. Only a faint amount of jesaconitine was detected, while aconitine, mesaconitine and hypaconitine were not detectable in the blood 24 h after ingestion. On the other hand, aconitine and its related alkaloids such as mesaconitine, jesaconitine, and hypaconitine were clearly detected in the urine.
本文描述了一例因误将乌头（鸟兜）当作可食用的草（枫叶笠）摄入而导致的意外乌头碱中毒致死病例。一名61岁男性在摄入后约2小时出现恶心、腹泻和身体不适症状，并被送往急诊室。复苏和抗心律失常药物均无效，出现室性心动过速和颤动并持续了6小时。他被转至冠心病监护病房，入院30小时后心电图显示完全窦性心律。患者陷入昏迷，第6天经CT诊断死于脑水肿。家属拒绝尸体解剖同意书，但同意进行气相色谱/选择离子监测（GC/SIM）以分析血液和尿液中乌头碱生物碱的毒性。摄入后24小时，血液中仅检测到微量的杰斯乌头碱，而未检测到乌头碱、中乌头碱和次乌头碱。另一方面，尿液中则清晰检测到乌头碱及其相关生物碱，如中乌头碱、杰斯乌头碱和次乌头碱。
