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A non-fatal intoxication with a high-dose sodium nitrate
Dorien Joosen1, Leo Stolk2, Ronald Henry1
1Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands.
BMJ Case Reports
|June 1, 2014
Summary
A man recovered after ingesting 75g of sodium nitrate, which can cause serious issues like methaemoglobinaemia. Early gastrointestinal symptoms may be mild, but monitoring is crucial for potential delayed complications.
Area of Science:
- Toxicology
- Emergency Medicine
Background:
- Sodium nitrate (NaNO3) ingestion is rare but can lead to severe toxicity.
- Toxicity arises from conversion to nitrite and nitric oxide, causing methaemoglobinaemia and vasodilation.
Observation:
- A 67-year-old male presented with immediate gastrointestinal symptoms after ingesting 75g of sodium nitrate.
- Initial physical examination revealed stable respiratory and hemodynamic status, with no cyanosis.
- Repeated methaemoglobin levels remained normal throughout his uneventful recovery.
Findings:
- Despite initial mild symptoms and normal methaemoglobin levels, sodium nitrate poisoning poses risks.
- Potential serious effects include methaemoglobinaemia and vasodilation due to nitrite and nitric oxide formation.
Implications:
- Mild initial symptoms do not preclude later serious complications from sodium nitrate toxicity.
- Continuous monitoring of respiratory and hemodynamic status is essential.
- Repeated blood gas analysis is recommended to detect potential methaemoglobinaemia.