Journal Published Online: 01 September 2000
Volume 45, Issue 5

A Non-fatal Case of Intoxication with Foxglove, Documented by Means of Liquid Chromatography-Electrospray-Mass Spectrometry



The non-fatal self-poisoning of a 36-year-old female patient, who ingested a concoction of foxglove (Digitalis Purpurea), is presented. On the admission, initial symptoms were nausea and vomiting, abdominal pain, and cardiovascular shock with sinus bradycardia. Blood and urine were assayed for 17 cardiotonic hetorosides, using a highly specific LC-MS procedure. Serum and urine specimens were collected over five days and analyzed by liquid chromatography-electrospray-mass spectrometry (LC-ES-MS). This accurate procedure allowed the determination of the digitalis glycosides and their metabolites in serum and urine. The serum concentrations of digitalis glycosides were maximum on the first day (gitoxin 13.1 ng/mL, digitoxin 112.6 ng/mL, digitoxigenin 3.3 ng/mL, and digitoxigenin mono-digitoxoside 8.9 ng/mL) and decreased over five days. We observed a peak gitaloxin level (112.6 ng/mL) on the fifth day only. After administration of atropine as well as dimeticone, alginic acid, and metoclopramide, health status improved. The peak urine concentrations were reached at hour 30 and were respectively 91.3 and 69.9 ng/mL for gitaloxin and digitoxin, while those of digitoxigenin, digitoxigenin mono-digoxoside and gitoxin were lower (respectively 0.7, 1, and 5.6 ng/mL). The patient was discharged on the fifth day when there were no residual symptoms.

Author Information

Lacassie, E
University Hospital, Limoges, Limoges Cedex, France
Marquet, P
University Hospital, Limoges, Limoges Cedex, France
Martin-Dupont, S
Emergency Unit, University Hospital, Limoges, France
Gaulier, J-M
University Hospital, Limoges, Limoges Cedex, France
Lachâtre, G
University Hospital, Limoges, Limoges Cedex, France Laboratory of Toxicology, Faculty of Pharmacy, Limoges, France
Pages: 5
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Stock #: JFS14845J
ISSN: 0022-1198
DOI: 10.1520/JFS14845J