Colchicum autumnale, which can be mistaken for Allium ursinum, contains the alkaloid
colchicine potentially leading to life-threatening up to fatal intoxications. We report
two cases of acute intoxications with unexplained circumstances. Using the authors'
systematic screening approaches, colchicine could be detected in blood plasma and
urine samples using liquid chromatography coupled to linear ion trap mass spectrometry (LC-ITMSn
) and high-resolution tandem mass spectrometry (LC-HRMS/MS).
Metabolites of colchicine could be identified in urine for confirmation of screening
results. Gas chromatography–mass spectrometry (GC-MS) analysis was also conducted, but colchicine could not be detected. Furthermore, colchicine concentration
was estimated via LC-HRMS/MS in plasma samples. Results of the systematic
screening indicated the ingestion of colchicine from both subjects. In both cases, the
parent compound was detected in blood plasma and urine using the LC-HRMS/MS
and LC-ITMSn system. An O-demethylation metabolite was identified in urine
samples of both subjects using LC-HRMS/MS; the N-deacetylation product was also
found in urine samples of both cases via LC-HRMS/MS and LC-ITMSn
. The use of
LC-ITMSn resulted only in the detection of the O-demethylation product in case
2. Plasma concentrations were estimated at 2.5 ng/ml and 4.7 ng/ml for cases 1 and
2, respectively. We demonstrated the detection of this highly toxic alkaloid in blood
plasma and urine using a time-saving and reliable clinical systematic screening.
Furthermore, we identified metabolites of colchicine being rarely discussed in
literature, which can be used as additional screening targets