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Fatal Taxus baccata ingestion with perimortem serum taxine B quantification |
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| Authors: | Ann M. Arens Tiffany C. Anaebere Howard Horng Kent Olson |
| Affiliation: | 1. Department of Emergency Medicine, University of California, San Francisco, CA, USA;2. San Francisco Division, California Poison Control System, San Francisco, CA, USA;3. Department of Emergency Medicine, Alameda Health System/Highland Hospital, Oakland, CA, USA;4. Department of Laboratory Medicine, University of California, San Francisco, CA, USA;5. San Francisco Division, California Poison Control System, San Francisco, CA, USA;6. Department of Medicine, University of California, San Francisco, CA, USA |
| Abstract: | Introduction: 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. Case presentation: 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. Conclusion: We report a perimortem serum and gastric taxine B and 3,5-DMP concentrations in a fatal case of T. baccata toxicity. |
| Keywords: | Taxus baccata common yew taxine B heart |