Citation

Harmon E, Lebin J, Murphy D, Watsjold B. BMJ Case Rep. 2019; 12(7): e2019-229947.

Affiliation

Emergency Medicine, University of Washington, Seattle, Washington, USA.

Copyright

(Copyright © 2019, BMJ Publishing Group)

DOI

10.1136/bcr-2019-229947

PMID

31350229

Abstract

While potassium cyanide poisoning has been well described, the toxicity of potassium gold cyanide is less well understood. [Potassium gold cyanide is a colorless to white crystalline powder, usually prepared by dissolving metallic gold in aqueous solution of potassium cyanide. It is most often used in gold plating applications.] 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.

© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.

Language: en

Keywords

emergency medicine; poisoning