Activists and rebel fighters accused Syrian President Bashar Assad’s forces of killing hundreds of civilians - including many women and children - in chemical weapons attacks on Wednesday.
Video clips apparently showing the graphic and disturbing aftermath of the alleged attacks on the rebel-held eastern Damascus suburb of Ghouta were posted to social media but could not be independently verified.
If confirmed, it would be by far the worst known use of poison gas during the country’s deadly civil war, which has claimed more than 100,000 lives.
British Foreign Secretary William Hague said in a statement he was “deeply concerned” by the reports, which he said would represent “a shocking escalation” in the conflict. He promised to raise the issue at the United Nations Security Council.
State television denied the reports, which it said were disseminated deliberately to distract United Nations chemical weapons experts who arrived in the country on Monday.
A spokesman for the Damascus military council of the Free Syria Army, who is in the area near where he attacks took place, said the death toll had reached more than 1,200. NBC News could not verify the claim.
Several towns and villages to the east and north of the capital were attacked by "chemical gas" and surface-to-surface missiles beginning around 2 a.m. Wednesday (7 p.m. Tuesday ET), the rebel spokesman said.
Many of those killed were woman and children. Symptoms witnessed in those who died included rapid breathing , constricted pupils, and foaming at the mouth, he added.
Conflicting death tolls from different sources could not immediately be reconciled by NBC News. Witness accounts are impossible to verify because Syria does not allow journalists to operate freely inside its borders.
The opposition Local Coordination Committees in Syria put the death toll at more than 755, saying several areas had been hit by “shelling with poisonous gases.”
It said the areas hit included Ein Tarma and Zamalka in eastern Ghouta and Mouadamieh in western Ghouta.
Bayan Baker, a nurse at a field hospital in Douma, told Reuters that death toll from the attack, collated from medical centers in the region, was 213.
"Many of the casualties are women and children. They arrived with their pupils dilated, cold limbs and foam in their mouths. The doctors say these are typical symptoms of nerve gas victims," she said.
The Syrian Revolution General Commission told regional news channel Al Arabiya that the death toll was at least 640, with hundreds of others reported wounded.
Intensive bombing in the area could be heard by residents in the city center, it reported.
One photo purportedly taken by activists in Douma showed the bodies of at least 16 children and three adults, one wearing combat fatigues, laid at the floor of a room in a medical facility where the bodies were collected, Reuters said.
Rami Abdul-Rahman, head of Britain-based Syrian Observatory for Human Rights, said the activists in the area said "poisonous gas" was fired in rockets as well as from the air. He added that regime forces were on a wide offensive on the eastern and western rebel-held suburbs of Damascus.
Abdul-Rahman said the observatory had been able to confirm more than 40 deaths from its activists on the ground.
NBC News' Charlene Gubash and Ammar Cheikhomar, Reuters and The Associated Press contributed to this report.