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A non-fatal oleander poisoning

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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.

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Authors and Affiliations

  1. Institute of Legal Medicine, Medical Faculty Carl Gustav Carus, Dresden Technical University, Fetscherstr. 74, 01307, Dresden, Germany

    J. Pietsch, K. Schulz & J. Dreßler

  2. Institute of Clinical Pharmacology, Medical Faculty Carl Gustav Carus, Dresden Technical University, Fetscherstr. 74, 01307, Dresden, Germany

    R. Oertel

  3. Section of Internal Medicine, University Hospital Carl Gustav Carus Dresden, Fetscherstr. 74, 01307, Dresden, Germany

    S. Trautmann

  4. Institute of Pharmacognosy, Faculty of Natural Sciences and Mathematics, University of Vienna, Althansstr. 14, 1090, Vienna, Austria

    B. Kopp

Authors
  1. J. Pietsch
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  2. R. Oertel
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  3. S. Trautmann
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  4. K. Schulz
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  5. B. Kopp
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  6. J. Dreßler
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Correspondence to J. Pietsch.

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Pietsch, J., Oertel, R., Trautmann, S. et al. A non-fatal oleander poisoning. Int J Legal Med 119, 236–240 (2005). https://doi.org/10.1007/s00414-005-0548-6

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  • DOI: https://doi.org/10.1007/s00414-005-0548-6

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