Detection of karakin poisoning using a targeted mass spectrometric workflow

Authors

  • D J Watson Division of Clinical Pharmacology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa
  • A Evans Division of Clinical Pharmacology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa
  • M Blockman Division of Clinical Pharmacology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa
  • L Wiesner Division of Clinical Pharmacology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

DOI:

https://doi.org/10.7196/SAMJ.2022.v112i12.16667

Keywords:

Toxicology, berries

Abstract

Treatment and management of plant toxicosis is made more difficult when an alien plant species is ingested, as identification of the toxin may pose a challenge. High-resolution mass spectrometers are required for the toxicological analysis of samples in these cases owing to their ability to scan large mass ranges and accurately identify mass features. We present this case to highlight the value of this technology in clinical toxicology. A middle-aged woman reported visual impairment, dizziness and numbness of her mouth and tongue following the ingestion of a berry. Over time her condition deteriorated, warranting toxicological analysis. The tree the berry came from was identified as Cornynocarpus laevigatus, which is known to produce the karakin neurotoxin. The patient’s samples and the husk and pulp of the berries were analysed using a high-resolution mass spectrometer. This resulted in the identification of the toxin in the berry kernel and husk and patient’s hair, suggesting that karakin could have contributed to the patient’s condition.

References

Marks CJ, van Hoving DJ. A 3-year survey of acute poisoning exposures in infants reported in telephone calls made to the Tygerberg Poison Information Centre, South Africa. S Afr J Child Health 2016;10(1):43. https://doi.org/10.7196/sajch.2016. v10i1.1045

Botha CJ, Penrith M-L. Poisonous plants of veterinary and human importance in southern Africa. J Ethnopharmacol 2008;119(3):549-558. https://doi.org/10.1016/j.jep.2008.07.022

Veale DJH, Wium CA, Müller GJ. Toxicovigilance I: A survey of acute poisoning in South Africa based on Tygerberg Poison Information Centre data. S Afr Med J 2012;103(5):293. https:// doi.org/10.7196/samj.6647

Eddleston M, Persson H. Acute plant poisoning and antitoxin antibodies. J Toxicol Clin Toxicol 2003;41(3):309-315. https:// doi.org/10.1081%2Fclt-120021116

Lazzaro L, Essl F, Lugliè A, Padedda BM, Pyšek P, Brundu G. Invasive Species and Human Health. Chapter 1: Invasive alien plant impacts on human health and well-being. Wallingford: CABI, 2018:16-33. http://www.cabi.org/cabebooks/ ebook/20183199715 (accessed 7 November 2022).

Wu AH, Gerona R, Armenian P, French D, Petrie M, Lynch KL. Role of liquid chromatography-high-resolution mass spectrometry (LC-HR/MS) in clinical toxicology. Clin Toxicol 2012;50(8):733-742. https://doi.org/10.3109/15563650.2012.7 13108

Shaw SD, Billing T. Karaka (Corynocarpus laevigatus) toxicosis in North Island brown kiwi (Apteryx mantelli). Vet Clin North Am Exot Anim Pract 2006;9(3):545-549. https://doi.org/10.1016/j. cvex.2006.05.014

National Center for Biotechnology Information. Karakin. PubChem Compound Summary for CID. PubChem,2022. https://pubchem.ncbi.nlm.nih.gov/compound/Karakin (accessed 25 March 2022).

Hamilton BF, Gould DH, Gustine DL. History of 3-nitropropionic acid. In: Paul R (ed). Mitochondrial

Inhibitors and Neurodegenerative Disorders. Totowa, NJ: Humana Press, 2000:21-33.

Skey W. Preliminary notes on the isolation of the bitter substance of the nut of the karaka tree

(Corynocarpus laevigata). Trans Preceedings New Zeal Inst 1871;4:316-321.

Pluskal T, Castillo S, Villar-Briones A, Orešič M. MZmine 2: Modular framework for processing, visualizing, and analyzing mass spectrometry-based molecular profile data. BMC Bioinformatics

;11(1):395. https://doi.org/10.1186/1471-2105-11-395

Chambers MC, Maclean B, Burke R, et al. A cross-platform toolkit for mass spectrometry and

proteomics. Nat Biotechnol 2012;30(10):918-920. https://doi.org/10.1038/nbt.2377

Kintz P. A new series of hair test results involving anabolic steroids. Toxicol Anal Clin 2017;29(3):320- 324. https://doi.org/10.1016/j.toxac.2017.05.003

Maurer HH. Hyphenated high-resolution mass spectrometry ‒ the ‘all-in-one’ device in analytical toxicology? Anal Bioanal Chem 2021;413(9):2303-2309. https://doi.org/10.1007/s00216-020-03064-y 15. Thoren KL, Colby JM, Shugarts SB, Wu AHB, Lynch KL. Comparison of information-dependent

acquisition on a tandem quadrupole TOF vs a triple quadrupole linear ion trap mass spectrometer for broad-spectrum drug screening. Clin Chem 2016;62(1):170-178. https://doi.org/10.1373/ clinchem.2015.241315

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Published

2022-12-01

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Section

In Practice

How to Cite

1.
Watson DJ, Evans A, Blockman M, Wiesner L. Detection of karakin poisoning using a targeted mass spectrometric workflow. S Afr Med J [Internet]. 2022 Dec. 1 [cited 2025 Oct. 7];112(12):901-3. Available from: https://samajournals.co.za/index.php/samj/article/view/540