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Fatal Methaemoglobinaemia Due To Intentional Sodium Nitrite Poisoning
G R Huntington1, J M Pennington1
1Barts Health NHS Trust, The Royal London Hospital, London.
Acute Medicine
|June 30, 2021
Summary
Sodium nitrite poisoning caused fatal methemoglobinemia in a young woman. Rapid diagnosis and treatment of severe methemoglobinemia are crucial for improved patient outcomes.
Area of Science:
- Toxicology
- Emergency Medicine
- Neurology
Background:
- Methemoglobinemia is a condition where hemoglobin is oxidized, reducing oxygen-carrying capacity.
- Sodium nitrite poisoning can rapidly induce severe methemoglobinemia.
Observation:
- A 28-year-old woman presented with collapse due to sodium nitrite poisoning.
- Initial venous blood gas revealed a critical methemoglobin level of 81%.
Findings:
- Treatment with methylene blue, sodium bicarbonate, and adrenaline led to a decrease in methemoglobin levels.
- Despite treatment, the patient developed extensive hypoxic brain injury, confirmed by CT head.
- Brain death was subsequently declared based on neurological testing.
Implications:
- Severe methemoglobinemia is a life-threatening condition with a high risk of rapid fatality.
- Prompt diagnosis and aggressive medical intervention are essential for potentially improving outcomes in methemoglobinemia cases.
- This case highlights the critical importance of timely management in acute poisoning scenarios.