Fatal poisoning due to aconite: Autopsy findings and postmortem quantitative analysis

Forensic Sci Med Pathol. 2023 Oct 2. doi: 10.1007/s12024-023-00728-w. Online ahead of print.

Abstract

Aconitum species are commonly used in traditional Chinese medicine, and they have a narrow therapy window due to the possibility of aconitine poisoning. Aconitine poisoning deaths appear infrequently in forensic practice. It is important to collect valuable body samples in time due to the rapid absorption and excretion of aconitine. However, it is unknown whether postmortem samples have value for toxicological analysis if the deceased has experienced long-term treatment before death. Herein, we present a case of a woman who died after 12 days of failed active treatment for aconitine poisoning. Aconitine was detected in the liver tissue. To our knowledge, this is the first case report describing the detection of aconitine in a decedent after long-term active treatment. The findings indicated that the aconitine concentration in liver tissue can be maintained after long-term treatment; this information may therefore serve as a reference in forensic practice.

Keywords: Aconitine poisoning; Autopsy; Postmortem toxicological analysis; Processing.