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An alarming increasing trend in suicides involving NaNO\n                    <jats:sub>2<\/jats:sub>\n                    ingestion has been recently observed. The aim of this study is to present a systematic review of intentional NaNO\n                    <jats:sub>2<\/jats:sub>\n                    poisonings, focusing on the epidemiological characteristics of the victims, their psychiatric history, the setting and circumstances of death, as well as autopsy, histological and toxicological results. A total of 24 papers satisfied the inclusion criteria reporting 94 suicides by NaNO\n                    <jats:sub>2<\/jats:sub>\n                    ingestion. Most victims were male (62.8%), belonging to the 13-40-year-old age group. Psychiatric history was available in 43 cases, with depression being the most reported disorder (19 cases). Autopsy and\/or external examination were performed in 63 cases, mostly showing unspecific signs of asphyxia and dark discoloration of the hypostasis and blood. Methemoglobin (Met-Hb) levels in blood were available in 49 suicides, ranging from 6 to 92%. In 35 cases levels exceeded 30%, with 19 victims showing concentrations above 50%. Nitrites (NO\n                    <jats:sub>2<\/jats:sub>\n                    ) and nitrates (NO\n                    <jats:sub>3<\/jats:sub>\n                    ) were analyzed from different biological samples including blood, urine, gastric content, and other tissues. NO\n                    <jats:sub>2<\/jats:sub>\n                    were detected in 44 cases, while NO\n                    <jats:sub>3<\/jats:sub>\n                    in 30 victims. Blood was the most analyzed matrix with NO\n                    <jats:sub>2<\/jats:sub>\n                    and NO\n                    <jats:sub>3<\/jats:sub>\n                    concentrations ranging from 0.03\u00a0\u00b5g\/mL to 372.65\u00a0\u00b5g\/mL and from 0.899\u00a0\u00b5g\/mL to 1,597.9\u00a0\u00b5g\/mL, respectively. In addition, a case of fatal self-poisoning by oral ingestion of NaNO\n                    <jats:sub>2<\/jats:sub>\n                    , which came to the author\u2019s attention, is presented.\n                  <\/jats:p>","DOI":"10.1007\/s12024-025-01066-9","type":"journal-article","created":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T07:37:23Z","timestamp":1756539443000},"page":"404-425","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Suicide by sodium nitrite ingestion: a systematic review"],"prefix":"10.1007","volume":"22","author":[{"given":"Edoardo","family":"Mazzini","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Feola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4344-9786","authenticated-orcid":false,"given":"Ilaria","family":"Fracassi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Carfora","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonietta","family":"Porzio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santina Alessandra","family":"Severino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariavictoria","family":"De Simone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo Pietro","family":"Campobasso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,30]]},"reference":[{"key":"1066_CR1","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2023.111610","author":"LJ Hikin","year":"2023","unstructured":"Hikin LJ, Ho J, Morley SR, Ahluwalia A, Smith PR. 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