Identification and Quantification of Thujone in a Case of Poisoning Due to Repeated Ingestion of an Infusion of Artemisia Vulgaris L.

Plants of the Artemisia genus are used worldwide as ingredients of botanical preparations. This paper describes the case of a 49-year-old man admitted to the emergency room at a Zurich hospital in a manic state after the ingestion of 1 L of an infusion of Artemisia vulgaris. Two monoterpenic ketones, α- and β-thujone, are present in various concentrations in Artemisia spp., but adverse effects have previously been associated only with essential oil from Artemisia absinthium and attributed to the inhibition of gamma-aminobutyric acid receptors, with consequent excitation and convulsions. The aim of this work was to examine and quantify the possible presence of thujone in the patient's serum and urine. A High Performance Liquid Chromatography (HPLC) method with isocratic separation and fluorescence detection (FLD) was set up and validated. Serum thujone concentrations were found to be 27.7 ± 3.48 μg/mL at day 0 and 24.1 ± 0.15 μg/mL on day 1. Results were confirmed by a gas chromatography with flame ionization detection (FID). Poisoning due to thujone was thus confirmed, suggesting four possible scenarios: (1) an unusually high concentration of thujone in the A. vulgaris ingested; (2) chronic exposure as the cause of the poisoning; (3) low metabolic efficiency of the patient; (4) contamination or adulteration of the plant material with other Artemisia spp., for example, A. absinthium. PRACTICAL APPLICATION These results could aid research in the field of adverse effects of botanicals, lead to better understanding and management of similar cases of poisoning, and promote more informed use of natural products.

[1]  A. Dawidowicz,et al.  The determination of α- and β-thujone in human serum - Simple analysis of absinthe congener substance. , 2016, Forensic science international.

[2]  Diana Obiștioiu,et al.  Chemical characterization by GC-MS and in vitro activity against Candida albicans of volatile fractions prepared from Artemisia dracunculus, Artemisia abrotanum, Artemisia absinthium and Artemisia vulgaris , 2014, Chemistry Central Journal.

[3]  O. Pelkonen,et al.  Thujone and thujone-containing herbal medicinal and botanical products: toxicological assessment. , 2013, Regulatory toxicology and pharmacology : RTP.

[4]  L. Bedoya,et al.  The Artemisia L. Genus: A Review of Bioactive Essential Oils , 2012, Molecules.

[5]  Olaf H Drummer,et al.  Validation of new methods. , 2007, Forensic science international.

[6]  S. Padosch,et al.  Absinthe—A Review , 2006, Critical reviews in food science and nutrition.

[7]  G. Skopp,et al.  Absinthe: attention performance and mood under the influence of thujone. , 2004, Journal of studies on alcohol.

[8]  J. Hinkelbein,.  Absinth - die Renaissance der grünen Fee , 2004 .

[9]  G. Shabir,et al.  Validation of high-performance liquid chromatography methods for pharmaceutical analysis. Understanding the differences and similarities between validation requirements of the US Food and Drug Administration, the US Pharmacopeia and the International Conference on Harmonization. , 2003, Journal of chromatography. A.

[10]  D. Rusyniak,et al.  Absinthe: return of the Green Fairy. , 2002, Seminars in neurology.

[11]  J. Casida,et al.  Detoxification of α- and β-Thujones (the Active Ingredients of Absinthe): Site Specificity and Species Differences in Cytochrome P450 Oxidation in Vitro and in Vivo , 2001 .

[12]  W. Arnold,et al.  Absinthe: what's your poison? , 1999 .

[13]  T. Landis,et al.  Plant-induced seizures: reappearance of an old problem , 1999, Journal of Neurology.

[14]  R. Dixon,et al.  Estrogenic Flavonoids from Artemisia vulgaris L. , 1998 .

[15]  B. Max.  This and that: cheap drinks and expensive drugs. , 1990, Trends in pharmacological sciences.

[16]  W. Arnold,et al.  Vincent van Gogh and the thujone connection. , 1988, JAMA.

[17]  B. Madea,et al.  Investigations on the medico-legal relevance of spirits containing thujone with special regard to to , 2005 .

[18]  B. Madea,et al.  Untersuchungen zur forensischen Relevanz thujonhaltiger Spirituosen unter besonderer Beruecksichtigung toxikologisch-analytischer Aspekte , 2005 .

[19]  A. DiTommaso,et al.  The biology of Canadian weeds. 118. Artemisia vulgaris L. , 2003 .