Two cases of fatal methemoglobinemia caused by self-poisoning with sodium nitrite: A case report.

Abstract

RATIONALE:

Sodium nitrite intoxication reportedly causes severe methemoglobinemia. Recent studies reported that most clinically significant cases resulted from intentional exposure in suicidal attempts. We describe 2 cases of severe methemoglobinemia secondary to intentional sodium nitrite intoxication in suicidal attempts.

PATIENTS CONCERNS:

A 26-year-old man and 20-year-old woman attempted suicide by taking sodium nitrite, and were brought to the emergency department.

DIAGNOSIS:

The male patient collapsed at the scene. He ingested approximately 18 g of sodium nitrate, and his methemoglobin level was 90.3%. The female patient was conscious, but was cyanotic. She ingested approximately 12.5 g of sodium nitrite, and her methemoglobin level was 54.6%.

INTERVENTIONS:

The male patient received advanced cardiac life support in the emergency department. Methylene blue was immediately administered for the female patient.

OUTCOMES:

The male patient died despite aggressive resuscitation. The female patient's cyanosis resolved, and her methemoglobin level decreased to 1.2% 3 hours later.

LESSONS:

The immediate administration of methylene blue in severe methemoglobinemia patients prevented fatal consequences. The public should be informed about the accessibility and toxicity of sodium nitrite.

• Authors: Sung Hoon Mun, Gwan Jin Park, Ji Han Lee, Young Min Kim, Hyun Seok Chai, Sang Chul Kim
• Journal: Medicine (Medicine (Baltimore)) Vol. 101 Issue 7 Pg. e28810 (Feb 18 2022) ISSN: 1536-5964 [Electronic] United States
• PMID: 35363170 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

Chemical References

• Sodium Nitrite
• Methylene Blue

Topics

• Cyanosis (chemically induced)
• Female
• Humans
• Male
• Methemoglobinemia (chemically induced)
• Methylene Blue (therapeutic use)
• Sodium Nitrite