Abstract
The study presents five fatal cases of poisoning with Taxus spp., all of which were suicides of young people aged between 16 and 26 years. Yew leaves were consumed in four fatalities, whereas a mash from Taxus was ingested in one case. No relevant concentrations of alcohol, narcotic drugs, and pharmaceuticals were determined in postmortem toxicological screening. At forensic autopsy, a widely dilated pupil was found in two decedents. Furthermore, autopsy showed unspecific findings of intoxication in all cases: acute blood congestion of lungs, liver, kidney, and brain as well as dilated cardiac ventricles. No signs of violence could be found in any of the fatalities. Yew leaves were identified in four cases in the stomach and duodenum. 3,5-Dimethoxyphenol, the aglycon of the Taxus ingredient taxicatine, was determined as toxicological evidence for the absorption of yew ingredients. Taxus intoxication could be confirmed by 3,5-dimethoxyphenol concentrations in cardiac blood between 31 and 528 ng/ml for all cases. 3,5-Dimethoxyphenol was also detected in stomach contents as well as in urine, liver, kidneys, and brain samples. Based on the different concentrations of 3,5-dimethoxyphenol determined in the cardiac blood samples, it was concluded that the form of ingestion plays a decisive role in the process of poisoning. Finally, a toxic range for Taxus poisoning based on 3,5-dimethoxyphenol as marker substance is proposed as orientation.
References
Wehner F, Gawatz O (2003) Suizidale Eibenintoxikationen-von Cäsar bis heute-oder Suizidanleitung im Internet. Arch Kriminol 211:19–26
Rätsch C (1998) Enzyklopädie der psychoaktiven Pflanzen. AT Verlag, Aarau
Rippe O, Majewski M, Amann M, Ochsner P, Rätsch C (2001) Paracelsusmedizin. AT Verlag, Aarau
Teuscher E, Lindequist U (1994) Biogene Gifte. Gustav Fischer, Stuttgart
Wilson CR, Sauer JM, Hooser SB (2001) Taxines: a review of the mechanism and toxicity of yew (Taxus spp.) alkaloids. Toxicon 39:175–185
Frohne D, Pribilla O (1965) Tödliche Vergiftung mit Taxus baccata. Arch Toxicol 21:150–162
Riano-Galan I, Cobo A, Lopez I, Garijo MG, Orejas G, Diaz C (1998) Possible intoxication by taxine: a report of 2 cases. An Esp Pediatr 49:211
Dach B von, Streuli RA (1988) Lidocainbehandlung einer Vergiftung mit Eibennadeln. Schweiz Med Wochenschr 118:1113–1116
Cummins RO, Haulman J, Quan L, Graves JR, Peterson D, Horan S (1990) Near-fatal yew berry intoxication treated with external cardiac pacing and digoxin-specific FAB antibody fragments. Ann Emerg Med 19:38–43
Sinn LE, Porterfield JF (1991) Fatal taxine poisoning from yew leaf ingestion. J Forensic Sci 36:599–601
Ingen G van, Visser R, Peltenburg H, Ark AM van der, Voortman M (1992) Sudden unexpected death due to Taxus poisoning. A report of five cases with review of the literature. Forensic Sci Int 56:81–87
Yersin B, Frey JG, Schaller MD, Nicod P, Perret C (1987) Fatal cardiac arrhythmias and shock following yew leaves ingestion. Ann Emerg Med 16:1396–1397
Beike J, Karger B, Meiners T, Brinkmann B, Köhler H (2003) LC–MS determination of Taxus alkaloids in biological specimen. Int J Legal Med 117:335–339
Frommherz L, Kintz P, Köhler H, Lehr M, Kijewski H, Brinkmann B, Beike J (2006) Quantitative determination of taxine B in body fluids by LC–MS–MS. Int J Legal Med (in press, p 1–6)
Musshoff F, Jacob B, Fowinkel C, Daldrup T (1993) Suicidal yew leave ingestion—phloroglucindimethylether (3,5-dimethoxyphenol) as a marker for poisoning from Taxus baccata. Int J Legal Med 106:45–50
Feldman R, Chrobak J, Liberek Z, Szajewski J (1988) 4 cases of poisoning with the extract of yew (Taxus baccata) needles. Pol Arch Med Wewn 79:26–29
Kite GC, Lawrence TJ, Dauncey EA (2000) Detecting Taxus poisoning in horses using LC/MS. Vet Hum Toxicol 42:151–154
Lang DG, Smith RA, Miller RE (1997) Detecting Taxus poisoning using GC/MS. Vet Hum Toxicol 39:314
Cope RB, Camp C, Lohr CV (2004) Fatal yew (Taxus sp.) poisoning in Willamette Valley, Oregon, horses. Vet Hum Toxicol 46:279–281
Helman RG, Fenton K, Edwards WC, Panciera RJ, Burrows GE (1996) Sudden death in calves due to Taxus ingestion. Agri-Pract 17:16–18
Jenniskens LHD, Rozendaal ELM van, Beek TA van, Wiegerinck PHG, Scheeren HW (1996) Identification of six taxine alkaloids from Taxus baccata needles. J Nat Prod 59:117–123
Tekol Y, Gögüsten B (1999) Comparative determination of the cardioselectivity of taxine and verapamil in the isolated aorta atrium, and jejunum preparations of rabbits. Arzneimittelforschung 49:673–678
Vanhaelen M, Duchateau J, Vanhaelen-Fastre R, Jaziri M (2002) Taxanes in Taxus baccata pollen: cardiotoxicity and/or allergenicity? Planta Med 68:36–40
Grothaus PG, Bignami GS, O’Malley S et al (1995) Taxane-specific monoclonal antibodies: measurement of taxol, baccatin III, and “total taxanes” in Taxus brevifolia extracts by enzyme immunoassay. J Nat Prod 58:1003–1014
Theodoridis G, Haasnot W, Cazemier G et al (2002) Immunoaffinity chromatography for the sample pretreatment of Taxus plant and cell extracts prior to analysis of taxanes by HPLC. J Chromatogr A 948:177–185
Holstege DM, Galey FD, Johnson B, Seibei JN (1996) Determination of alkaloid exposure in a model ruminant (goat) using a multiresidue screening method. J Agric Food Chem 44:2310–2315
Glowniak K, Wawrzynowicz T, Hajnos M, Mroczek T (1999) The application of zonal thin-layer chromatography to the determination of paclitaxel and 10-deacetylbaccatin III in some Taxus species. JPC J Planar Chromatogr Mod TLC 12:328–335
Tiwary AK, Puschner B, Kinde H, Tor ER (2005) Diagnosis of Taxus (yew) poisoning in a horse. J Vet Diagn Invest 17:252–255
Theodoridis G, Verpoorte R (1996) Taxol analysis by HPLC: a review. Phytochem Anal 7:169–184
Rozendaal ELM van, Lelyveld GP, Beek TA van (1997) A simplified method for the determination of taxanes in yew needles by reversed-phase (C-18) HPLC. Phytochem Anal 8:286–293
Adeline MT, Wang XP, Poupat C, Ahond A, Potier P (1997) Evaluation of taxoids from Taxus sp. crude extracts by HPLC. J Liq Chromatogr 20:3135–3145
Mroczek T, Glowniak K (2001) Solid-phase extraction and simplified HPLC determination of 10-deacetalbaccatin III and related taxoids in yew species. J Pharm Biomed Anal 26:89–102
Vesela D, Saman D, Valterova I, Vanek T (1999) Seasonal variations in the content of taxanes in the bark of Taxus baccata L. Phytochem Anal 10:319–321
Cass BJ, Scott DS, Legge RL (1999) Determination of taxane concentrations in Taxus canadensis clippings using HPLC analysis with an internal standard. Phytochem Anal 10:88–92
Madhusudanan KP, Chattopadhyay SK, Tripathi V, Sashidhara KV, Kumar S (2002) MS/MS profiling of taxoids from the needles of Taxus wallichiana. Phytochem Anal 13:18–30
Theodoridis G, Laskaris G, Rozendahl ELM van, Verpoorte R (2001) Analysis of taxines in Taxus plant material and cell cultures by HPLC photodiode array and HPLC-electrospray MS. J Liq Chromatogr 24:2267–2282
Merz KW, Preuβ FR (1941) Konstitution und Synthese von Taxicatin. Arch Pharm (Weinheim) 279:134–148
Merz KW, Preuβ R (1943) Zur Kenntnis der Inhaltsstoffe der Eibe. Arch Pharm (Weinheim) 281:205–216
Rast D, McInnes AG, Neish AC (1964) Application of GC to the neutral, water soluble constituents of twigs of some gymnosperms. Phytochemistry 3:103–108
Roth L, Daunderer M, Kormann K (1994) Giftpflanzen-Pflanzengifte. Nikol, Hamburg
Pelissier-Alicot AL, Gaulier JM, Champsaur P, Marquet P (2003) Mechanisms underlying postmortem redistribution of drugs: a review. J Anal Toxicol 27:533–543
Lewis WH, Elvin-Lewis MPF (1977) Medical botany. Wiley, New York
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Pietsch, J., Schulz, K., Schmidt, U. et al. A comparative study of five fatal cases of Taxus poisoning. Int J Legal Med 121, 417–422 (2007). https://doi.org/10.1007/s00414-006-0099-5
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DOI: https://doi.org/10.1007/s00414-006-0099-5