A non-fatal oleander poisoning.

Abstract

The study presents a case of non-fatal poisoning with oleander blooms in a 47-year-old female, with emphasis on the importance of toxicological service in a clinical emergency. After repeated vomiting at home, the patient was admitted at the hospital with cardiac symptoms more than 18 h after the ingestion. Serum samples were assayed immunochemically for digitoxin-related compounds by electrochemiluminescent immunoassay, and using HPLC/MS/MS analysis for oleandrin, the main cardiac glycoside of Nerium oleander. Confirming the non-specific immunoassay results, which are often clinically over-interpreted, oleandrin was detected by HPLC/MS/MS in the serum sample in a concentration of 1.6 ng/ml upon admission. Comparison with previous reports indicates that single compound analysis only permits a toxicological assessment for oleander poisoning and results in the proposal to classify an oleandrin level between 1.0 and 2.0 ng/ml as toxic blood plasma/serum concentration.

• Authors: J Pietsch, R Oertel, S Trautmann, K Schulz, B Kopp, J Dressler
• Journal: International journal of legal medicine (Int J Legal Med) Vol. 119 Issue 4 Pg. 236-40 (Jul 2005) ISSN: 0937-9827 [Print] Germany
• PMID: 15906057 (Publication Type: Case Reports, Comparative Study, Journal Article)

Chemical References

• Cardenolides
• oleandrin

Topics

• Cardenolides (analysis)
• Chromatography, High Pressure Liquid (methods)
• Female
• Humans
• Immunoassay (methods)
• Luminescent Measurements (methods)
• Mass Spectrometry (methods)
• Middle Aged
• Nerium (poisoning)
• Poisoning (diagnosis)
• Sensitivity and Specificity