Analysis of toxic Veratrum alkaloids in plant samples from an accidental poisoning case

Purpose Four individuals (aged 50-60 years) at a dinner ate a wild plant that had been collected in a forest and looked similar to the edible wild plant Hosta montana (plantain lily). About 30-40 min after eating the plant, two of these individuals suffered from severe vomiting and a rapid decrease in blood pressure, and were hospitalized. Another individual initially showed mild symptoms, but was then hospitalized as symptoms increased in severity. The last person did not show any symptoms. The plant was found to be the very toxic Veratrum species. Methods Although biological specimens were not available in this case, the remaining uncooked Veratrum sample was analyzed to determine what compounds contributed to the poisoning symptoms by liquid chromatography-tandem mass spectrometry. Results Two toxic alkaloids, protoveratrines A and B, were identified and quantified at 146 and 1302 mu g/g, respectively. Reproducible experiments showed that the cooked samples contained 400-600 mu g/g levels of protoveratrine B. Protoveratrine A and B are the most toxic compounds in Veratrum alkaloids. Other toxic Veratrum alkaloids were also present in trace amounts or not detected. Thus, the patients' symptoms were assigned to protoveratrine B poisoning. To prevent further poisoning, wild Veratrum species were collected from two other colonies over years and analyzed. The composition of Veratrum alkaloids of the poisoning sample and that of the young Veratrum sprout samples of two other colonies were very similar, and had not changed largely over the years when they were young sprouts, showing that all the young sprouts of Veratrum species are dangerous to eat. Conclusions This is a rare report on the direct correlation of protoveratrine B ingestion with poisoning symptoms.