A comparative study of five fatal cases of Taxus poisoning

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.

Suicidal yew ingestion

“…Intoxications by parts of the yew plant or their leaves are well described in the literature, whereas suicidal cases of yew ingestion are rarely known [1,2]. On the other hand taxine is used as a cytostatic agent.…”

“…In the past only few reported cases with a clear toxicological proof of the resorption of yew ingredients were known [2]. Usually the evidence of yew leaves are proved by plant anatomical investigations [2,3].…”

Application of direct PCR in a forensic case of yew poisoning

“…chromatography combined with UV, diode array detection and MS [4]. But the toxicologically relevant content and composition of Taxus spp.-derived materials vary widely depending on the species (respective cultivar) [9,10], the habitat (climate), the season and the type of sample [11][12][13].…”

“…are evergreen conifers that have been implicated with animal [1,2] and human poisonings [3,4]. Some Taxus species and cultivars are commonly used in ornamental horticulture and landscaping.…”

Suicidal poisoning with mercaptodimethur–morphological findings and toxicological analysis

“…Lethal poisonings by pharmaceutical drugs [9] and illicit drugs [4] seem to have increased. However, fatal poisonings with plant toxins are relatively rare [5,11], and intoxications with plant protecting agents have even decreased [13].…”