Citation

Mun SH, Park GJ, Lee JH, Kim YM, Chai HS, Kim SC. Medicine (Baltimore) 2022; 101(7): e28810.

Copyright

(Copyright © 2022, Lippincott Williams and Wilkins)

DOI

10.1097/MD.0000000000028810

PMID

35363170

PMCID

PMC9282115

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.

Language: en

Keywords

Humans; Female; Male; Sodium Nitrite; Methemoglobinemia; Cyanosis; Methylene Blue