[Two suicide fatalities from sodium cyanide ingestion: differences in blood biochemistry]

We report a case of two suicide fatalities from sodium cyanide ingestion, which showed differences in pathology and blood biochemistry. The victims were a married couple in their 70 years of age, owners of a gilding factory. They were found dead in their bedroom by a family member. Suicide notes and sodium cyanide powder were found in the room. Autopsy revealed eroded gastric mucosae in both victims. In the male, the stomach showed a previous postoperative state of partial resection, and the lungs were more congested and edematous in the male than in the female. In both victims, cyanide was detected in the blood at markedly high concentrations. In postmortem blood biochemistry, a marked elevation of cardiac troponin T, I and CK-MB was observed in the peripheral blood of the male, whereas there was only a mild elevation in the female. In the male, erythropoietin was also markedly elevated. These observations suggested a difference in the dying process following sodium cyanide ingestion between the victims; survival time may have been longer in the male than the female. The absorption of cyanide may have been a contributory factor to the difference.