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Article
December 16, 1988

Pediatric Cyanide Intoxication and Death From an Acetonitrile-Containing Cosmetic

Author Affiliations

From the Division of Emergency Medicine and Inter-mountain Regional Poison Control Center, University of Utah, Salt Lake City (Dr Caravati); and the National Capital Poison Center, Georgetown University Hospital, Washington, DC (Dr Litovitz).

From the Division of Emergency Medicine and Inter-mountain Regional Poison Control Center, University of Utah, Salt Lake City (Dr Caravati); and the National Capital Poison Center, Georgetown University Hospital, Washington, DC (Dr Litovitz).

JAMA. 1988;260(23):3470-3473. doi:10.1001/jama.1988.03410230088034
Abstract

Two cases of pediatric accidental ingestion of an acetonitrile-containing cosmetic are reported. One of the children, a 16-month-old boy, was found dead in bed the morning after ingesting the product. No therapy had been undertaken, as the product was mistakenly assumed to be an acetone-containing nail polish remover. The second child, a 2-year-old boy, experienced signs of severe cyanide poisoning, but survived with vigorous supportive care. Both children had blood cyanide levels in the potentially lethal range. The observed delayed onset of severe toxic reactions supports the proposed mechanism of acetonitrile conversion to inorganic cyanide via hepatic microsomal enzymes. Physicians and poison centers should be alerted to the existence of this highly toxic product, sold for removal of sculptured nails and likely to be confused with the less toxic acetone-containing nail polish removers. We urge regulatory agencies to reconsider the wisdom of marketing a cosmetic that poses such an extreme health hazard.

(JAMA 1988;260:3470-3473)

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