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Two fatal cases of acetone cyanohydrin poisoning: case report and literature review

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Abstract

Acetone cyanohydrin (ACH), an organic cyanide, is mainly used in the production of methyl methacrylate (MMA), and it also exists in cassava roots, the main calorie source in some tropical countries. ACH can decompose spontaneously or enzymatically into acetone and highly toxic hydrogen cyanide (HCN) and be potentially toxic to its contacts. Given that limited forensic studies and case reports on fatal ACH poisoning are available, herein, we present a report of two fatal cases of ACH poisoning in which the two victims, with postmortem cyanide blood concentrations of 4.22 μg/ml and 4.07 μg/ml, suffered from acute poisoning of ACH due to a traffic accident. Furthermore, a literature review of cyanide poisoning case reports from 2000 to 2020 was carried out, and 28 subjects with cyanide poisoning were presented, including the age, sex, cause of poisoning, autopsy findings and the cyanide concentration in the blood. ACH poisoning lacks specific and reliable autopsy findings for diagnosis, and relevant toxicological studies are necessary. Due to the chemical properties of ACH that allow it to easily decompose, the toxicological analysis of acetone and cyanide in biological samples is essential for the diagnosis of ACH poisoning.

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Funding

This research was funded by National Natural Science Foundation of China (Grant No. 82002001) and Natural Science Foundation of Liaoning Province (Grant No. 20180530004).

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  1. Department of Forensic Pathology, School of Forensic Medicine, China Medical University, Shenyang, 110122, P. R. China

    Zhipeng Cao, Dawei Guan & Xu Wu

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  1. Zhipeng Cao
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  2. Dawei Guan
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  3. Xu Wu
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Correspondence to Dawei Guan or Xu Wu.

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Cao, Z., Guan, D. & Wu, X. Two fatal cases of acetone cyanohydrin poisoning: case report and literature review. Forensic Sci Med Pathol 17, 700–705 (2021). https://doi.org/10.1007/s12024-021-00425-6

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