Practical Laboratory Medicine (Aug 2024)

Accidental bufotoxin intoxication: Arenobufagin identification by liquid chromatography coupled to mass spectrometry

  • Alessandro Bonari,
  • Mauro Leucio Mattei,
  • Giovanni Cappelli,
  • Francesca Romano,
  • Nicoletta Cini,
  • Francesca Luceri,
  • Donato Squillaci,
  • Stefano Dugheri,
  • Alessandra Fanelli,
  • Nicola Mucci

Journal volume & issue
Vol. 41
p. e00424

Abstract

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Background: Since ancient times, poisoning, even serious poisoning, has been known to occur during nature walks. Intentional or unintentional ingestion of toxins of animal origin is one of the possible causes of poisoning. Bufadienolide poisoning is a critical case. This is because of its high potency and its ability to cross the blood-brain barrier. Due to the rarity of these poisonings in humans in Central Europe, their identification is often difficult. The following is a case report of a poisoning by toad eggs in an Italina child, that presented vertigo, fussiness and sleepiness. A method of toxin identification using the prince of pharmacotoxicology, liquid chromatography (LC) coupled with tandem mass spectrometry (MS/MS), and an innovative reasoning were used. This method can be applied to other poisoning cases.

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