Öz
Sodium nitrite is an agent used as both a food preservative and an antimicrobial agent, and it is easily accessible. When taken in high doses, it can be life-threatening due to its ability to cause methemoglobinemia. Our case report examines the intentional ingestion of sodium nitrite for suicidal purposes and discusses its clinical management. The patient was brought to the emergency room displaying symptoms of nausea, vomiting, hypoxemia, and peripheral cyanosis. Methemoglobinemia was detected in the blood gas, and the patient's relative confirmed the history of sodium nitrite ingestion. Supportive treatment was initiated until methylene blue was provided. Given its easy accessibility, sodium nitrite intoxication should be included in the differential diagnosis for patients presenting with intoxication and methemoglobinemia. Initiating methylene blue treatment as soon as possible is crucial for the patient's recovery prognosis.
Anahtar Kelimeler
Sodium nitrite methemoglobinemia suicide peripheral cyanosis
Etik Beyan
Does not require an ethical declaration.
Destekleyen Kurum
None
Teşekkür
None
Kaynakça
- 1. Cvetković D, Živković V, Lukić V. et al. Sodium nitrite food poisoning in one family. Forensic Sci Med Pathol. 2019; 15: 102–105.
- 2. Howland M. Nitrites (Amyl and Sodium) and Sodium Thiosulfate. In: Nelson LS, Howland M, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS. eds. Goldfrank's Toxicologic Emergencies, 11e. McGraw-Hill Education; 2019. Accessed February 24, 2025.
- 3. Wright RO, Lewander WJ, Woolf AD. Methemoglobinemia: etiology, pharmacology, and clinical management. Ann Emerg Med. 1999;34(5):646-56.
- 4. Erickson TB, Thompson TM, Lu JJ. The approach to the patient with an unknown overdose. Emergency medicine clinics of North America, 2007;25(2), 249-281.
- 5. Toxidromes. Holstege, CP, Borek HA. Critical Care Clinics. 2012; 28(4): 479 – 498.
- 6. Katabami K, Hayakawa M, Gando S. Severe methemoglobinemia due to sodium nitrite poisoning. Case reports in emergency medicine. 2016; (1): 9013816.
- 7. Padovano M, Aromatario M, D'Errico S, et al. Sodium Nitrite Intoxication and Death: Summarizing Evidence to Facilitate Diagnosis. Int J Environ Res Public Health. 2022;19(21):13996.
Öz
Sodyum nitrit hem gıda koruyucu hem de antimikrobiyal ajan olarak kullanılan bir maddedir ve kolayca erişilebilir. Yüksek dozlarda alındığında, methemoglobinemiye neden olma yeteneği nedeniyle yaşamı tehdit edebilir. Olgu sunumumuz, intihar amaçlı kasıtlı sodyum nitrit yutulmasını inceliyor ve klinik yönetimini tartışıyor. Hasta, bulantı, kusma, hipoksemi ve periferik siyanoz semptomları göstererek acil servise getirildi. Kan gazında methemoglobinemi tespit edildi ve hastanın yakını sodyum nitrit yutma öyküsünü doğruladı. Metilen mavisi sağlanana kadar destekleyici tedavi başlatıldı. Kolay erişilebilirliği göz önüne alındığında, zehirlenme ve methemoglobinemi ile gelen hastalarda sodyum nitrit zehirlenmesi ayırıcı tanıya dahil edilmelidir. Metilen mavisi tedavisine mümkün olan en kısa sürede başlanması, hastanın iyileşme prognozu için çok önemlidir.
Anahtar Kelimeler
Kaynakça
- 1. Cvetković D, Živković V, Lukić V. et al. Sodium nitrite food poisoning in one family. Forensic Sci Med Pathol. 2019; 15: 102–105.
- 2. Howland M. Nitrites (Amyl and Sodium) and Sodium Thiosulfate. In: Nelson LS, Howland M, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS. eds. Goldfrank's Toxicologic Emergencies, 11e. McGraw-Hill Education; 2019. Accessed February 24, 2025.
- 3. Wright RO, Lewander WJ, Woolf AD. Methemoglobinemia: etiology, pharmacology, and clinical management. Ann Emerg Med. 1999;34(5):646-56.
- 4. Erickson TB, Thompson TM, Lu JJ. The approach to the patient with an unknown overdose. Emergency medicine clinics of North America, 2007;25(2), 249-281.
- 5. Toxidromes. Holstege, CP, Borek HA. Critical Care Clinics. 2012; 28(4): 479 – 498.
- 6. Katabami K, Hayakawa M, Gando S. Severe methemoglobinemia due to sodium nitrite poisoning. Case reports in emergency medicine. 2016; (1): 9013816.
- 7. Padovano M, Aromatario M, D'Errico S, et al. Sodium Nitrite Intoxication and Death: Summarizing Evidence to Facilitate Diagnosis. Int J Environ Res Public Health. 2022;19(21):13996.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Tıp Eğitimi |
| Bölüm | Olgu Sunumu |
| Yazarlar | |
| Gönderilme Tarihi | 13 Mayıs 2025 |
| Kabul Tarihi | 22 Ağustos 2025 |
| Yayımlanma Tarihi | 30 Eylül 2025 |
| DOI | https://doi.org/10.7197/cmj.1698412 |
| IZ | https://izlik.org/JA73HB46JW |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 47 Sayı: 3 |