A toxic self-made beverage: Analytics of alkaloids from Veratrum album by LC-MS/MS

A 49-year-old man consumed two glasses (approx. 2 x 20 ml) of a beverage containing yellow gentian (Gentiana lutea). Shortly after ingestion, he developed nausea, vomiting and oral paraesthesia. On admission to the hospital he suffered from severe bradycardia and hypotension and he was treated with activated charcoal, antiemetics, atropine and i.v. volume. The patient completely recovered from the symptoms within 24 hours and was discharged from the hospital. The initial suspicion of Veratrum poisoning was confirmed by identifying protoveratrines A (ProA) and protoveratrine B (ProB) in a sample from the beverage as well as in the patients serum by LC-(ESI)-MS-MS.