An Autopsy Case of Fatal Methemoglobinemia due to Ingestion of Sodium Nitrite

Minori Nishiguchi Hideyuki Nushida

doi:10.4172/2157-7145.1000262

Abstract

We herein present an autopsy case of fatal methemoglobinemia due to suicidal ingestion of sodium nitrite. A man in his 30s who had exhibited mild depression was found dead in his house. A glass containing a white turbid solution and a suicide note were found on the table near the decedent. At autopsy, the lividity of the face and back was greenish gray, and the blood was tinted a chocolate brown color. Toxicological analysis of nitrite and nitrate using a colorimetric method showed that the nitrite concentrations were <0.05 and 0.09 μg/mL and that the nitrate concentrations were 71.69 and 83.48 μg/mL in the heart and femoral blood, respectively. Biochemical analysis after death showed that the level of methemoglobin was 83.4% by spectrophotometry. We conclude that the cause of death was severe methemoglobinemia following acute poisoning induced by sodium nitrite ingestion, although the blood nitrite concentration did not reach the fatal level.

Highlights

Sodium nitrite has long been used as a color enhancer in cured meats and fishes, a preservative, and an antimicrobial agent worldwide [1,2]
We conclude that the cause of death was severe methemoglobinemia following acute poisoning induced by sodium nitrite ingestion, the blood nitrite concentration did not reach the fatal level
Nitrite and nitrate was detected in heart and femoral blood, and the nitrite in neither blood sample reached lethal levels

Summary

Introduction

Sodium nitrite has long been used as a color enhancer in cured meats and fishes, a preservative, and an antimicrobial agent worldwide [1,2]. In North American and European countries, where large amounts of sodium nitrite are added to food, many cases of methemoglobinemia caused by accidental ingestion or inhalation of nitrites have been reported [1,2,3,4,5]. Few cases of fatal poisoning by nitrites in food have been reported in Japan [6,7]. As food additives, ingestion are not associated with poisoning symptoms, whereas acute exposure to excessive dosages may be associated with lethal symptoms such as methemoglobinemia

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Results

Conclusion