Multidirectional analysis for a colchicine poisoning case revealed detail cause of death and its mechanism |
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| Institution: | 1. Department of Legal Medicine, Asahikawa Medical University, 2-1-1-1 Midorigaoka-Higashi, Asahikawa, Hokkaido 078-8510, Japan;2. Department of Forensic Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan;3. Division of Tumor Pathology, Department of Pathology, Asahikawa Medical University, 2-1-1-1 Midorigaoka-Higashi, Asahikawa, Hokkaido 078-8510, Japan;4. Department of Forensic Medicine, School of Medicine, International University of Health and Welfare, 4-3 Kozunomori, Narita 286-8686, Japan;1. Legal Medicine, Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95123 Catania, Italy;2. Department G.F. Ingrassia, Laboratory of Forensic Toxicology, University of Catania, 95123 Catania, Italy;3. Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy;1. Institute of Evidence Law and Forensic Science, China University of Political Science and Law, Beijing, China;2. Key Laboratory of Forensic Toxicology, Ministry of Public Security, China;3. National Narcotics Laboratory, Drug Intelligence and Forensic Center of the Ministry of Public Security, China;1. Department of Anatomy, Catholic Institute for Applied Anatomy, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea;2. Division of Forensic Odontology and Disaster Oral Medicine, Department of Forensic Science, Iwate Medical University, 1-1-1, Idaidori, Yahaba-cho, Shiwa-gun, Iwate 028-3694, Japan;1. University of Goettingen, (Univ.-Prof. Emeritus), Fiorilloweg 1, D – 37075 Goettingen, Germany;2. Department of Diagnostic Radiology I, University Hospital of Goettingen, Robert-Koch-Str. 40, D – 37073 Goettingen, Germany;3. Institute of Forensic Medicine, Justus-Liebig-University Giessen, Frankfurter Str. 58, D – 35392 Giessen, Germany;1. Research and Education Faculty, Medical Sciences Cluster, Health Service Center, Kochi University, Kochi, Japan;2. National Research Institute of Police Science, Chiba, Japan |
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| Abstract: | The appearance of Meadow saffron (Colchicum autumnale), which contains colchicine, closely resembles Alpine leek (Allium victorialis), a popular edible wild vegetable in Northern Japan. This often results in the accidental ingestion of Meadow saffron and acute colchicine poisoning deaths. Here, we report on a case of acute colchicine poisoning death caused by the accidental ingestion of Meadow saffron. A man in his 70 s had been given wild vegetables from his neighborhood, which were then cooked and eaten by himself and his wife. Several hours later, they suffered from abdominal pain, vomiting, and diarrhea. They immediately went to the hospital and received routine treatment. While his wife made a full recovery, he died at home two days after consumption of the vegetables. A forensic autopsy was conducted five days after ingestion of the Meadow saffron and a lethal concentration (21.5 ng/mL) of colchicine in the peripheral blood sample was detected by liquid chromatography-tandem mass spectrometry. Distribution of colchicine in body fluids, tissues and gastrointestinal contents was also investigated. Some of the plants he had eaten were identified as Alpine leek or Meadow saffron by genetic analysis of his stomach contents. Histopathological examination showed apoptotic cells and cell cycle arrest at the metaphase in the intestinal crypts and testis. In addition, we detected high concentrations of endotoxins and tumor necrosis factor-α in his blood, indicating that intestinal mucosal injury induced by colchicine poisoning had allowed endotoxins to invade the body, causing death by endotoxin shock. |
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| Keywords: | Colchicine Tissue distribution Intestinal barrier Endotoxin |
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