title: Fatal methemoglobinemia caused by inadvertent contamination of a laxative solution with sodium nitrite.
abstract: We describe two cases of fatal methemoglobinemia resulting from ingestion of laxative solution inadvertently contaminated with sodium nitrite. Postmortem toxicological examination revealed methemoglobin levels in excess of 75% in both patients--a level that is uniformly fatal. The laxative solution was found to contain sodium nitrite instead of sodium sulphate at a concentration of 15 g/l. The pathophysiology of methemoglobinemia and a review of other reported cases of toxic methemoglobinemia are presented. Marked cyanosis in the face of intact cardiorespiratory function should alert the physician to the possibility of toxic methemoglobinemia.
authors.affiliation: Department of Medicine C, Sapir Medical Center (Meir Hospital), Kfar Saba, Israel.
authors.forename: M
authors.initials: M
authors.lastname: Ellis
authors.forename: Y
authors.initials: Y
authors.lastname: Hiss
authors.forename: L
authors.initials: L
authors.lastname: Shenkman
mesh_terms: D000368:Aged; D002400:Cathartics / Q000506:poisoning*; D004340:Drug Contamination; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008708:Methemoglobinemia / Q000139:chemically induced / Q000401:mortality*; D012977:Sodium Nitrite / Q000506:poisoning*
chemical_list: D002400:Cathartics; D012977:Sodium Nitrite