ArticleActa medica Lituanic2025
Fatal Outcome of Suicidal Multi-Substance Ingestion Involving Sodium Nitrate and Nitrite Toxicity: A Case Report and Literature Review.
Article in Acta medica Lituanic, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Suicide by sodium nitrite ingestion: a systematic review.Forensic science, medicine, and pathology · 2026Pooled it
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Nitrate and nitrite toxicity, particularly from sodium nitrite and sodium nitrate ingestion, has become a critical public health issue due to its role in accidental poisoning, foodborne exposure, and intentional self-harm. Sodium nitrite, commonly used in food preservation, is increasingly linked to suicide, with online resources providing accessible information on lethal dosages. This trend underscores an urgent need for regulatory action and preventive strategies. This report details a fatal case of nitrate and nitrite toxicity in a 19-year-old female, presenting a complex toxicological profile involving ethyl alcohol, amphetamines, and additional pharmaceuticals. Materials and methods: A systematic literature search was conducted across Case presentation: A 19-year-old female was found deceased in her home, alongside a suicide note indicating intent to self-harm through ingestion of sodium nitrate, sodium nitrite, and multiple medications. The autopsy findings included cherry-brown lividity, dark, non-coagulated blood within the heart chambers, and significant multi-organ congestion, consistent with methemoglobinemia and systemic hypoxia. Toxicology results confirmed a blood alcohol concentration of 1.22‰, with trace levels of amphetamine, atropine, and quetiapine, while nitrites detected in the gastric contents confirmed sodium nitrite as a primary toxic agent. The toxic synergy of these substances ultimately led to fatal multi-organ compromise. Conclusions: This case emphasizes the serious risks associated with nitrate and nitrite ingestion, particularly in instances of intentional overdose facilitated by readily accessible online information on lethal dosages. The autopsy findings reveal characteristic signs of methemoglobinemia and systemic hypoxia; however, a thorough forensic assessment must also consider additional factors, including the presence of a suicide note, the scene context, and any substances collected at the location. Lessons: Due to the inherent instability of nitrite in blood, its post-mortem detection is often challenging, thereby complicating toxicological confirmation. The increasing accessibility and misuse of sodium nitrite underscore an urgent need for regulatory oversight, public awareness, and enhanced preventive measures to address the rising incidence of intentional sodium nitrite toxicity, particularly within at-risk populations.
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