{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T22:51:16Z","timestamp":1759963876474},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Cyanide (CN) is one among the most potent and rapidly acting lethal poisons, and it may cause death unless immediately diagnosed and treated. We report an unusual case of pediatric CN poisoning after ingestion of apricot kernels containing amygdalin, who survived with antidotal therapy and hemodialysis. A 3-year-old girl presented with respiratory distress and coma following tonic-clonic convulsions after ingestion of 3 apricot kernels. She had severe metabolic acidosis (pH 6.91, bicarbonate [HCO<jats:sub>3<\/jats:sub>\n                           <jats:sup>\u2212<\/jats:sup>] 5.6 mEq\/L, base excess \u221226.0 mEq\/L). Her blood CN level was measured 3.15 mg\/L, 3 hours after ingestion. Hydroxocobalamin could not be administered immediately because it had to be brought from a medical center 4 hours apart. Therefore, a 3-hour hemodialysis session was carried out, following which she showed some clinical improvement. In addition, when hydroxocobalamin was obtained, it was then administered. During follow-up, she was completely asymptomatic with blood pressure, and other hemodynamic parameters normalized. This case presents hemodialysis as a way to correct metabolic derangements from CN poisoning and suggests that it may have a role in select cases of pediatric CN poisoning, especially when CN-scavenging antidotes may be unavailable.<\/jats:p>","DOI":"10.1097\/pec.0000000000001644","type":"journal-article","created":{"date-parts":[[2018,11,6]],"date-time":"2018-11-06T22:53:17Z","timestamp":1541544797000},"page":"e582-e584","source":"Crossref","is-referenced-by-count":4,"title":["Role of Hemodialysis in the Management of Cyanide Intoxication From Apricot Kernels in a 3-Year-Old Child"],"prefix":"10.1097","volume":"36","author":[{"given":"Tahir","family":"Dalk\u0131ran","sequence":"first","affiliation":[{"name":"Intensive Care Unit"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasar","family":"Kandur","sequence":"additional","affiliation":[{"name":"Pediatric Nephrology, Necip Faz\u0131l City Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mustafa","family":"Ozaslan","sequence":"additional","affiliation":[{"name":"Paediatrics"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Can","family":"Ac\u0131payam","sequence":"additional","affiliation":[{"name":"Paediatric Hematology and Oncology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seref","family":"Olgar","sequence":"additional","affiliation":[{"name":"Paediatric Cardiology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2018,11,6]]},"reference":[{"key":"bib1-20231002","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1111\/j.1742-6723.2012.01538.x","article-title":"Review article: management of cyanide poisoning","volume":"24","year":"2012","journal-title":"Emerg Med Australas"},{"key":"bib2-20231002","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1053\/j.ajkd.2011.05.018","article-title":"Approach to the evaluation of a patient with an increased serum osmolal gap and high-anion-gap metabolic acidosis","volume":"58","year":"2011","journal-title":"Am J Kidney Dis"},{"key":"bib3-20231002","first-page":"338","article-title":"Functional diversifications of cyanogenic glucosides","volume":"13","year":"2010","journal-title":"Curr Opin Plant Biol"},{"key":"bib4-20231002","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1016\/S0196-0644(98)70077-0","article-title":"Acute cyanide toxicity caused by apricot kernel ingestion","volume":"32","year":"1998","journal-title":"Ann Emerg Med"},{"key":"bib5-20231002","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1111\/1742-6723.12462","article-title":"Apricot kernels: a rare case of cyanide toxicity","volume":"27","year":"2015","journal-title":"Emerg Med Australas"},{"key":"bib6-20231002","first-page":"496","article-title":"Cyanide intoxication by apricot kernel ingestion as complimentary cancer therapy","volume":"71","year":"2013","journal-title":"Neth J Med"},{"key":"bib7-20231002","first-page":"3","article-title":"The reliability of the Glasgow Coma Scale: a systematic review","volume":"42","year":"2006","journal-title":"Intensive Care Med"},{"key":"bib9-20231002","doi-asserted-by":"crossref","first-page":"70","DOI":"10.12659\/AJCR.881827","article-title":"Fatal cyanide poisoning in a child, caused by eating apricot seeds","volume":"12","year":"2011","journal-title":"Am J Case Rep"},{"key":"bib10-20231002","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1007\/s10354-014-0340-7","article-title":"Severe cyanide poisoning from an alternative medicine treatment with amygdalin and apricot kernels in a 4-year-old child","volume":"165","year":"2015","journal-title":"Wien Med Wochenschr"},{"key":"bib11-20231002","doi-asserted-by":"crossref","first-page":"341","DOI":"10.3109\/15563658408992565","article-title":"The cyanide content of laetrile preparations, apricot, peach and apple seeds","volume":"22","year":"1984","journal-title":"J Toxicol Clin Toxicol"},{"key":"bib12-20231002","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1001\/jama.1979.03290300013008","article-title":"Cyanide poisoning from apricot seeds","volume":"241","year":"1979","journal-title":"JAMA"},{"key":"bib13-20231002","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1093\/occmed\/48.7.427","article-title":"Cyanide poisoning: pathophysiology and treatment recommendations","volume":"48","year":"1998","journal-title":"Occup Med (Lond)"},{"key":"bib14-20231002","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1097\/00043764-199507000-00004","article-title":"Pharmacologic mechanism of antidotes in cyanide and nitrile poisoning","volume":"37","year":"1995","journal-title":"J Occup Environ Med"},{"key":"bib15-20231002","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1016\/S0196-0644(05)81988-2","article-title":"Cyanide and methemoglobin kinetics in smoke inhalation victims treated with the cyanide antidote kit","volume":"22","year":"1993","journal-title":"Ann Emerg Med"},{"key":"bib16-20231002","doi-asserted-by":"crossref","first-page":"367","DOI":"10.3109\/15563658108990043","article-title":"Cyanide poisoning","volume":"18","year":"1981","journal-title":"Clin Toxicol"},{"key":"bib17-20231002","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1016\/0735-6757(95)90162-0","article-title":"The clinical experience of acute cyanide poisoning","volume":"13","year":"1995","journal-title":"Am J Emerg Med"},{"key":"bib18-20231002","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1177\/0960327107070566","article-title":"Cyanide: critical issues in diagnosis and treatment","volume":"26","year":"2007","journal-title":"Hum Exp Toxicol"},{"key":"bib19-20231002","doi-asserted-by":"crossref","first-page":"1901","DOI":"10.2169\/internalmedicine.54.4272","article-title":"High anion gap metabolic acidosis after a suicide attempt with cyanide: the rebirth of cyanide poisoning","volume":"54","year":"2015","journal-title":"Intern Med"},{"key":"bib20-20231002","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1097\/01.mat.0000227670.39719.ec","article-title":"Dialysis for thiocyanate intoxication: a case report and review of the literature","volume":"52","year":"2006","journal-title":"ASAIO J"},{"key":"bib21-20231002","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1159\/000166918","article-title":"Treatment of acute cyanide intoxication with hemodialysis","volume":"5","year":"1985","journal-title":"Am J Nephrol"},{"key":"bib22-20231002","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1177\/039139888901200601","article-title":"Cyanide poisoning: pathophysiology and current approaches to therapy","volume":"12","year":"1989","journal-title":"Int J Artif Organs"},{"key":"bib23-20231002","article-title":"Cyanide poisoning and its treatment","volume":"24","year":"2004","journal-title":"Pharmacotherapy"},{"key":"bib25-20231002","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1136\/emj.03.2011.3932rep","article-title":"Hydroxocobalamin treatment of acute cyanide poisoning from apricot kernels","volume":"28","year":"2011","journal-title":"Emerg Med J"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000001644","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T21:07:05Z","timestamp":1696280825000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000001644"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11,6]]},"references-count":23,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000001644","relation":{},"ISSN":["1535-1815","0749-5161"],"issn-type":[{"value":"1535-1815","type":"electronic"},{"value":"0749-5161","type":"print"}],"subject":[],"published":{"date-parts":[[2018,11,6]]}}}