ISSN: 0022-1198
CODEN: JFSCA
Published Online: 1 October 1979
Page Count: 4

Death Associated with Nitrite Ingestion: Report of a Case
Jones, AM
Toxicologist, pathologist, toxicologist, and investigator, Office of the Medical Investigator, University of New Mexico School of Medicine,

Street, E
Toxicologist, pathologist, toxicologist, and investigator, Office of the Medical Investigator, University of New Mexico School of Medicine,

Standefer, JC
Toxicologist, pathologist, toxicologist, and investigator, Office of the Medical Investigator, University of New Mexico School of Medicine,

Inserra, R
Toxicologist, pathologist, toxicologist, and investigator, Office of the Medical Investigator, University of New Mexico School of Medicine,

(Received 22 December 1978; accepted 7 May 1979)

Abstract

Sodium nitrite reacts with the ferrous iron of hemoglobin and oxidizes it to ferric (Fe³⁺) iron. This converts hemoglobin to methemoglobin, which does not react with oxygen, and thus the oxygen-carrying capacity of blood is reduced. Poisoning from accidental ingestion of sodium nitrite has been reported [1–5], and although it has been suggested that a dose of 2 mg/kg body weight will cause toxic symptons [1], recovery was reported when up to 30 mg/kg body weight (2 to 30 mg/kg body weight) was ingested and medical treatment was available within minutes. Death was reported following an accidental ingestion by a four-month-old infant of a “small amount” of 4% ethyl nitrite in liquid formula. The concentration of methemoglobin in blood from this infant was 80% of the total hemoglobin, while that of the surviving twin who had consumed less of the formula was 38% [2]. Generally, survivors have had methemoglobin levels of less than 60%, and prompt treatment with methylene blue has limited the morbidity. We present a case of suicidal sodium nitrite poisoning that caused death within 1 h and resulted in detectable concentrations of both nitrite and nitrate in certain tissues.

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Paper ID: JFS10905J
DOI: 10.1520/JFS10905J
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