Fatality from potassium gold cyanide poisoning. 2019

Elizabeth Harmon, and Jacob Lebin, and David Murphy, and Bjorn Watsjold
Emergency Medicine, University of Washington, Seattle, Washington, USA.

While potassium cyanide poisoning has been well described, the toxicity of potassium gold cyanide is less well understood. This case describes an 84-year-old man who presented after an intentional ingestion of 0.5-1 teaspoons of potassium gold cyanide. Despite antidotal therapy, the patient rapidly developed severe lactic acidosis, multiorgan dysfunction and ultimately expired. While the patient's clinical findings were consistent with acute cyanide poisoning, a serum cyanide level was below the toxic threshold. Previous reports have suggested that gold toxicity may also contribute to the effects of potassium gold cyanide, and may have played a role in the patient's rapid decline. In addition to treatment of cyanide toxicity, management of acute gold toxicity should also be considered in potassium gold cyanide ingestion.

UI MeSH Term Description Entries
D008297 Male Males
D011190 Potassium Cyanide A highly poisonous compound that is an inhibitor of many metabolic processes, but has been shown to be an especially potent inhibitor of heme enzymes and hemeproteins. It is used in many industrial processes. Potassium Cyanide (K(14)CN),Potassium Cyanide (K(C(15)N)),Cyanide, Potassium
D003485 Cyanates Organic salts of cyanic acid containing the -OCN radical. Cyanate
D006046 Gold A yellow metallic element with the atomic symbol Au, atomic number 79, and atomic weight 197. It is used in jewelry, goldplating of other metals, as currency, and in dental restoration. Many of its clinical applications, such as ANTIRHEUMATIC AGENTS, are in the form of its salts.
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000140 Acidosis, Lactic Acidosis caused by accumulation of lactic acid more rapidly than it can be metabolized. It may occur spontaneously or in association with diseases such as DIABETES MELLITUS; LEUKEMIA; or LIVER FAILURE. Lactic Acidosis
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D013405 Suicide The act of killing oneself. Suicides
D017612 Gold Compounds Inorganic compounds that contain gold as an integral part of the molecule. Compounds, Gold

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