Poisoning and Drug Laboratory Division, Critical Care and Emergency Center, Iwate Medical University Hospital, 3-16-1 Honchoudori, Morioka, Iwate 020-0015, Japan.
J Anal Toxicol. 2011 Mar;35(2):119-23. doi: 10.1093/anatox/35.2.119.
A patient committed suicide with hydrogen sulfide (H(2)S) by combining two commercial products. The patient was given hydroxocobalamin as an antidote in addition to treatment with cardiopulmonary resuscitation, but died approximately 42 min after his arrival at the hospital. The patient's cause of death was attributed to acute hydrogen sulfide poisoning. Serum concentrations of sulfide before and after administration of hydroxocobalamin were 0.22 and 0.11 μg/mL, respectively; serum concentrations of thiosulfate before and after hydroxocobalamin administration were 0.34 and 0.04 μmol/mL, respectively. Hydroxocobalamin is believed to form a complex with H(2)S in detoxification pathways of H(2)S. Although H(2)S is rapidly metabolized and excreted, the decreased sulfide concentration may be also associated with this complex formation. The decreased sulfide concentration suggests that hydroxocobalamin therapy may be effective for acute H(2)S poisoning. The decreased thiosulfate concentration seems to be associated with formation of a thiosulfate/hydroxocobalamin complex, because hydroxocobalamin can form a complex with thiosulfate. The thiosulfate concentration decreased to a greater extent than did sulfide, suggesting that hydroxocobalamin has a higher affinity for thiosulfate than for H(2)S. Therefore, prompt administration of hydroxocobalamin after H(2)S exposure may be effective for H(2)S poisoning.
一位患者将两种商业产品混合使用硫化氢（H2S）自杀。除心肺复苏治疗外，还给予患者羟钴胺作为解毒剂，但患者到达医院后约 42 分钟死亡。患者的死亡原因被归因于急性硫化氢中毒。羟钴胺给药前后的血清硫化物浓度分别为 0.22 和 0.11μg/mL；羟钴胺给药前后的硫代硫酸盐浓度分别为 0.34 和 0.04μmol/mL。羟钴胺被认为在 H2S 的解毒途径中与 H2S 形成复合物。尽管 H2S 被迅速代谢和排泄，但硫化物浓度的降低也可能与这种复合物的形成有关。硫化物浓度的降低表明羟钴胺治疗可能对急性 H2S 中毒有效。硫代硫酸盐浓度的降低似乎与硫代硫酸盐/羟钴胺复合物的形成有关，因为羟钴胺可以与硫代硫酸盐形成复合物。硫代硫酸盐的浓度降低程度大于硫化物，表明羟钴胺对硫代硫酸盐的亲和力高于 H2S。因此，在 H2S 暴露后立即给予羟钴胺可能对 H2S 中毒有效。
