title: Antidote treatment for cyanide poisoning with hydroxocobalamin causes bright pink discolouration and chemical-analytical interferences.
abstract: Here we report the case of a 70-year-old woman who committed suicide by cyanide poisoning. During resuscitation cares, she underwent an antidote treatment by hydroxocobalamin. Postmortem investigations showed marked bright pink discolouration of organs and fluids, and a lethal cyanide blood concentration of 43 mg/L was detected by toxicological investigation. Discolouration of hypostasis and organs has widely been studied in forensic literature. In our case, we interpreted the unusual pink coloration as the result of the presence of hydroxocobalamin. This substance is a known antidote against cyanide poisoning, indicated because of its efficiency and poor adverse effects. However, its main drawback is to interfere with measurements of many routine biochemical parameters. We have tested the potential influence of this molecule in some routine postmortem investigations. The results are discussed.
authors.affiliation: University Center of Legal Medicine, Geneva-Lausanne, Rue Michel-Servet 1, 1211 Geneva, Rue de Bugnon 21, 1011 Lausanne, Switzerland.
authors.forename: C
authors.initials: C
authors.lastname: Brunel
authors.forename: C
authors.initials: C
authors.lastname: Widmer
authors.forename: M
authors.initials: M
authors.lastname: Augsburger
authors.forename: F
authors.initials: F
authors.lastname: Dussy
authors.forename: T
authors.initials: T
authors.lastname: Fracasso
mesh_terms: D000368:Aged; D000931:Antidotes / Q000008:administration & dosage*; D002555:Cerebrospinal Fluid; D003486:Cyanides / Q000097:blood / Q000506:poisoning*; D004388:Dura Mater / Q000473:pathology; D005260:Female; D049429:Forensic Pathology; D006801:Humans; D006879:Hydroxocobalamin / Q000008:administration & dosage*; D010496:Pericardium / Q000473:pathology; D010859:Pigmentation Disorders / Q000139:chemically induced*; D010994:Pleura / Q000473:pathology; D011041:Poisoning / Q000188:drug therapy; D020545:Respiratory Mucosa / Q000473:pathology; D012535:Scalp / Q000473:pathology; D013405:Suicide; D014513:Ureter / Q000473:pathology; D019459:Urothelium / Q000473:pathology; D014822:Vitreous Body
chemical_list: D000931:Antidotes; D003486:Cyanides; D006879:Hydroxocobalamin