International Journal of Legal Medicine

, Volume 119, Issue 4, pp 236–240

A non-fatal oleander poisoning

  • J. Pietsch
  • R. Oertel
  • S. Trautmann
  • K. Schulz
  • B. Kopp
  • J. Dreßler
Case Report

DOI: 10.1007/s00414-005-0548-6

Cite this article as:
Pietsch, J., Oertel, R., Trautmann, S. et al. Int J Legal Med (2005) 119: 236. doi:10.1007/s00414-005-0548-6

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.

Keywords

Nerium oleanderOleandrinPoisoningImmunoassayHPLC/MS/MS

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • J. Pietsch
    • 1
  • R. Oertel
    • 2
  • S. Trautmann
    • 3
  • K. Schulz
    • 1
  • B. Kopp
    • 4
  • J. Dreßler
    • 1
  1. 1.Institute of Legal Medicine, Medical Faculty Carl Gustav CarusDresden Technical UniversityDresdenGermany
  2. 2.Institute of Clinical Pharmacology, Medical Faculty Carl Gustav CarusDresden Technical UniversityDresdenGermany
  3. 3.Section of Internal MedicineUniversity Hospital Carl Gustav Carus DresdenDresdenGermany
  4. 4.Institute of Pharmacognosy, Faculty of Natural Sciences and MathematicsUniversity of ViennaViennaAustria