Severe Acute Poisoning with Homemade Aconitum napellus Capsules: Toxicokinetic and Clinical Data

Aconitum napellus is an extremely dangerous plant that contains various toxic diterpenoid alkaloids, mainly aconitine, primarily concentrated in the roots. We report a case of acute intoxication of a 21-year-old man admitted to our Emergency Department after the ingestion, in order to sleep, of thre...

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Published inClinical toxicology (Philadelphia, Pa.) Vol. 43; no. 7; pp. 873 - 876
Main Authors Moritz, Fabienne, Compagnon, Patricia, Kaliszczak, Isabelle Guery, Kaliszczak, Yann, Caliskan, Valérie, Girault, Christophe
Format Journal Article
LanguageEnglish
Published England Informa UK Ltd 01.01.2005
Taylor & Francis
Subjects
Aconitine
Aconitum - poisoning
Aconitum napellus
Acute Disease
Adult
Half life
Humans
Male
Plant Preparations - blood
Plant Preparations - poisoning
Plasmatic dosage
Poisoning - blood
Poisoning - therapy
Toxicokinetic
Treatment Outcome
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Summary:Aconitum napellus is an extremely dangerous plant that contains various toxic diterpenoid alkaloids, mainly aconitine, primarily concentrated in the roots. We report a case of acute intoxication of a 21-year-old man admitted to our Emergency Department after the ingestion, in order to sleep, of three homemade Aconitum napellus capsules. Capsules were measured to contain 237 mg of root and 19 µg of aconitine. The patient experienced the first symptoms on wakening 5 hours later with generalized paresthesia, nausea, diarrhea, vertigo, thoracic pain, dyspnea, and dyschromatopsia. At admission, 7 hours after intake, electrocardiographic analysis showed a sinusal bradycardia with polymorphic and bigeminal ventricular extrasystolia. Cardiovascular and neurological symptoms disappeared, respectively, within 11 and 13 hours of ingestion. The patient was discharged from the ICU on day 2. Plasmatic concentrations at H7, H9, H14, H19, and after ingestion were, respectively, of 1.75, 0.75, 0.35, and 0.02 ng/mL. The calculated half-life of aconitine was 3 hours. To our knowledge, this is the first reported case with an aconitine toxicokinetic-effect relationship. The authors stress that clinicians must be aware of possible occurrence of acute poisoning with Aconitum napellus in European countries and in the United States as herbal medicine is becoming increasingly popular.
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ISSN:1556-3650
1556-9519
DOI:10.1080/15563650500357594