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  • Title: Two cases of fatal methemoglobinemia caused by self-poisoning with sodium nitrite: A case report.
    Author: Mun SH, Park GJ, Lee JH, Kim YM, Chai HS, Kim SC.
    Journal: Medicine (Baltimore); 2022 Feb 18; 101(7):e28810. PubMed ID: 35363170.
    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.
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