Cholestatic hepatitis caused by acute gold potassium cyanide poisoning.
BACKGROUND
Poisoning after oral ingestion of gold potassium cyanide is rarely reported. A case of suicidal ingestion of gold potassium cyanide (potassium dicyanoaurate; CAS# 13967-50-5) is described.


METHODS
A 27-year-old man attempted suicide by ingesting 5 mL gold potassium cyanide solution. He developed vomiting, hyperamylasemia, and hepatic dysfunction. Cyanide poisoning was not detected but acute gold toxicity was noted. Pathologic findings of the liver showed centrilobular cholestasis with eosinophilic degeneration. The whole blood and serum gold were 4361 and 6011 microg/L, respectively, and the 24-hour urine gold was 429 microg/d in samples obtained on day 4.


CONCLUSIONS
Gold-induced hepatotoxicity has been seen infrequently in patients receiving gold therapy. Reported agents include sodium aurothiomalate, sodium aurothiopropranol sulfonate, aurothioglucose, aurothiopolypeptide (Auro-detoxin), auric sulfide, and gold thiosulfate, our report adds gold potassium cyanide.
Wu
M L
ML
Department of Medicine, Taipei Veterans General Hospital, National Yang-Ming University, Taiwan. mlwu@vghtpe.gov.tw
Tsai
W J
WJ
Ger
J
J
Deng
J F
JF
Tsay
S H
SH
Yang
M H
MH
D000208:Acute Disease; D000328:Adult; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology* / Q000473:pathology; D002780:Cholestasis, Intrahepatic / Q000209:etiology* / Q000473:pathology; D003485:Cyanates; D003486:Cyanides / Q000506:poisoning*; D006046:Gold / Q000097:blood / Q000652:urine; D017612:Gold Compounds / Q000506:poisoning*; D006801:Humans; D008099:Liver / Q000187:drug effects / Q000473:pathology; D008297:Male; D012016:Reference Values; D013406:Suicide, Attempted
D003485:Cyanates; D003486:Cyanides; D017612:Gold Compounds; C043041:gold cyanide; D006046:Gold