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Hydroxocobalamin treatment of acute cyanide poisoning from apricot kernels.
Emerg Med J. 2011 Sep; 28(9):804-5.EM

Abstract

Clinical experience with hydroxocobalamin in acute cyanide poisoning via ingestion remains limited. This case concerns a 35-year-old mentally ill woman who consumed more than 20 apricot kernels. Published literature suggests each kernel would have contained cyanide concentrations ranging from 0.122 to 4.09 mg/g (average 2.92 mg/g). On arrival, the woman appeared asymptomatic with a raised pulse rate and slight metabolic acidosis. Forty minutes after admission (approximately 70 min postingestion), the patient experienced headache, nausea and dyspnoea, and was hypotensive, hypoxic and tachypnoeic. Following treatment with amyl nitrite and sodium thiosulphate, her methaemoglobin level was 10%. This prompted the administration of oxygen, which evoked a slight improvement in her vital signs. Hydroxocobalamin was then administered. After 24 h, she was completely asymptomatic with normalised blood pressure and other haemodynamic parameters. This case reinforces the safety and effectiveness of hydroxocobalamin in acute cyanide poisoning by ingestion.

Authors+Show Affiliations

UOS di Tossicologia Clinica, Azienda Ospedaliera Universitaria Integrata, Verona, Italy. davide.cigolini@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

21856998

Citation

Cigolini, Davide, et al. "Hydroxocobalamin Treatment of Acute Cyanide Poisoning From Apricot Kernels." Emergency Medicine Journal : EMJ, vol. 28, no. 9, 2011, pp. 804-5.
Cigolini D, Ricci G, Zannoni M, et al. Hydroxocobalamin treatment of acute cyanide poisoning from apricot kernels. Emerg Med J. 2011;28(9):804-5.
Cigolini, D., Ricci, G., Zannoni, M., Codogni, R., De Luca, M., Perfetti, P., & Rocca, G. (2011). Hydroxocobalamin treatment of acute cyanide poisoning from apricot kernels. Emergency Medicine Journal : EMJ, 28(9), 804-5. https://doi.org/10.1136/emj.03.2011.3932rep
Cigolini D, et al. Hydroxocobalamin Treatment of Acute Cyanide Poisoning From Apricot Kernels. Emerg Med J. 2011;28(9):804-5. PubMed PMID: 21856998.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hydroxocobalamin treatment of acute cyanide poisoning from apricot kernels. AU - Cigolini,Davide, AU - Ricci,Giogio, AU - Zannoni,Massimo, AU - Codogni,Rosalia, AU - De Luca,Manuela, AU - Perfetti,Paola, AU - Rocca,Giampaolo, PY - 2011/8/23/entrez PY - 2011/8/23/pubmed PY - 2011/11/9/medline SP - 804 EP - 5 JF - Emergency medicine journal : EMJ JO - Emerg Med J VL - 28 IS - 9 N2 - Clinical experience with hydroxocobalamin in acute cyanide poisoning via ingestion remains limited. This case concerns a 35-year-old mentally ill woman who consumed more than 20 apricot kernels. Published literature suggests each kernel would have contained cyanide concentrations ranging from 0.122 to 4.09 mg/g (average 2.92 mg/g). On arrival, the woman appeared asymptomatic with a raised pulse rate and slight metabolic acidosis. Forty minutes after admission (approximately 70 min postingestion), the patient experienced headache, nausea and dyspnoea, and was hypotensive, hypoxic and tachypnoeic. Following treatment with amyl nitrite and sodium thiosulphate, her methaemoglobin level was 10%. This prompted the administration of oxygen, which evoked a slight improvement in her vital signs. Hydroxocobalamin was then administered. After 24 h, she was completely asymptomatic with normalised blood pressure and other haemodynamic parameters. This case reinforces the safety and effectiveness of hydroxocobalamin in acute cyanide poisoning by ingestion. SN - 1472-0213 UR - https://wwww.unboundmedicine.com/medline/citation/21856998/Hydroxocobalamin_treatment_of_acute_cyanide_poisoning_from_apricot_kernels_ L2 - https://emj.bmj.com/lookup/pmidlookup?view=long&pmid=21856998 DB - PRIME DP - Unbound Medicine ER -