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August 8, 1977

Fatal Cyanide Poisoning: Accidental Ingestion of Amygdalin

JAMA. 1977;238(6):482. doi:10.1001/jama.1977.03280060026012

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To the Editor. —  Amygdalin (laetrile) tablets can release hydrocyanic acid on exposure to hydrolytic enzymes. To our knowledge, no fatality due to such poisoning has been reported to date. We wish to draw attention to the fact that when ingested accidentally by young children, amygdalin tablets may constitute a potentially fatal hazard.

Report of a Case.—  An 11-month-old girl accidentally ingested from one to five 500-mg amygdalin tablets. The tablets belonged to the child's father who has a malignant neoplasm. They were thought to be harmless by the parents and were contained in a vial along with an assortment of vitamin tablets. The patient became listless within half an hour after ingestion and vomited. Emesis was induced again by the mother who then rushed the child to the local hospital when her breathing became irregular and her state of consciousness became altered. An hour after ingestion, she was in