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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:\u00a0A systematic literature search was conducted across\u00a0PubMed\u00a0and\u00a0Google Scholar\u00a0databases, spanning articles published over a period of the last 10 years, utilizing keywords relevant to the topic under consideration and their combinations. 58 pertinent articles were selected, supplemented by data from the\u00a0Lithuanian State Forensic Medicine Service, involving a clinical case. Autopsy findings, toxicological analyses, and contextual details were meticulously examined to elucidate the mechanism and circumstances of death.Case presentation:\u00a0A 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\u2030, 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:\u00a0This 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:\u00a0Due 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.<\/jats:p>","DOI":"10.15388\/amed.2025.32.1.11","type":"journal-article","created":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T07:36:28Z","timestamp":1742801788000},"page":"160-172","source":"Crossref","is-referenced-by-count":4,"title":["Fatal Outcome of Suicidal Multi-Substance Ingestion Involving Sodium Nitrate and Nitrite Toxicity: A Case Report and Literature Review"],"prefix":"10.15388","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-5156-6329","authenticated-orcid":false,"given":"Sofija Saul\u0117","family":"Kaubryt\u0117","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9104-9835","authenticated-orcid":false,"given":"Sigitas","family":"Chmieliauskas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giedr\u0117","family":"Salyklyt\u0117","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sigitas","family":"Laima","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8415-5998","authenticated-orcid":false,"given":"Diana","family":"Vasiljevait\u0117","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2501-7602","authenticated-orcid":false,"given":"Jurgita","family":"Stasi\u016bnien\u0117","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paulius","family":"Petreikis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1794-2259","authenticated-orcid":false,"given":"Robertas","family":"Badaras","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"6097","published-online":{"date-parts":[[2025,3,24]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Bowles EF, Burleigh M, Mira A, Van Breda SGJ, Weitzberg E, Rosier BT. Nitrate: \"the source makes the poison.\" Crit Rev Food Sci Nutr. 2024;30:1-27. doi:10.1080\/10408398.2024.2395488","DOI":"10.1080\/10408398.2024.2395488"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Tusiewicz K, Kuropka P, Workiewicz E, Wache\u0142ko O, Szpot P, Zawadzki M. Nitrites: An Old Poison or a Current Hazard? Epidemiology of Intoxications Covering the Last 100 Years and Evaluation of Analytical Methods. Toxics. 2023;11(10):832. doi:10.3390\/toxics11100832","DOI":"10.3390\/toxics11100832"},{"key":"ref2","unstructured":"Richard AM, Diaz JH, Kaye AD. Reexamining the risks of drinking-water nitrates on public health. Ochsner J. 2014;14(3):392-398."},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Deganello Saccomani M, Cavarzere P, Silvagni D, Dal Corso S, Perlini S, Biban P. A 5-Month-Old Infant with Diffuse Cyanosis and No Other Symptoms. Pediatr Ann. 2016;45(4):e116-119. doi:10.3928\/00904481-20160303-01","DOI":"10.3928\/00904481-20160303-01"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Taus F, Pigaiani N, Bortolotti F, Mazzoleni G, Brevi M, Tagliaro F, et al. Direct and specific analysis of nitrite and nitrate in biological and non-biological samples by capillary ion analysis for the rapid identification of fatal intoxications with sodium nitrite. Forensic Sci Int. 2021;325:110855. doi:10.1016\/j.forsciint.2021.110855","DOI":"10.1016\/j.forsciint.2021.110855"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Gariglio S, David MC, Mattia A, Consalvo F, Scopetti M, Padovano M, et al. Evaluation of Spontaneous Overtime Methemoglobin Formation in Post-Mortem Blood Samples from Real Cases in Critical Storage Conditions. 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Forensic Sci Int. 2021;326:110907. doi:10.1016\/j.forsciint.2021.110907","DOI":"10.1016\/j.forsciint.2021.110907"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Stephenson L, Wills S, van den Heuvel C, Humphries M, Byard RW. Increasing use of sodium nitrite in suicides-an emerging trend. Forensic Sci Med Pathol. 2022;18(3):311-318. doi:10.1007\/s12024-022-00471-8","DOI":"10.1007\/s12024-022-00471-8"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"Dur\u00e3o C, Pedrosa F, Dinis-Oliveira RJ. Another suicide by sodium nitrite and multiple drugs: an alarming trend for \"exit\"? Forensic Sci Med Pathol. 2021;17(2):362-366. doi:10.1007\/s12024-020-00340-2","DOI":"10.1007\/s12024-020-00340-2"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"Sz\u00f3r\u00e1dov\u00e1 A, Hojs\u00edk D, Zdar\u00edlek M, Valent D, Ni\u017enansk\u00fd \u013d, Kov\u00e1cs A, et al. Modern suicide trend from internet. Leg Med (Tokyo). 2024;67:102384. doi:10.1016\/j.legalmed.2023.102384","DOI":"10.1016\/j.legalmed.2023.102384"},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"Vodovar D, Tournoud C, Boltz P, Paradis C, Puskarczyk E. Severe intentional sodium nitrite poisoning is also being seen in France. Clin Toxicol (Phila). 2022;60(2):272-274. doi:10.1080\/15563650.2021.1919695","DOI":"10.1080\/15563650.2021.1919695"},{"key":"ref18","doi-asserted-by":"publisher","unstructured":"O'Neill C, Najjar Z, Ingleton A, Edwards A, Dawson A, Gupta L. Methaemoglobinaemia associated with the atypical use of sodium nitrite as a food additive. Med J Aust. 2021;215(6):256-257.e1. doi:10.5694\/mja2.51233","DOI":"10.5694\/mja2.51233"},{"key":"ref19","doi-asserted-by":"publisher","unstructured":"Cvetkovi\u0107 D, \u017divkovi\u0107 V, Luki\u0107 V, Nikoli\u0107 S. Sodium nitrite food poisoning in one family. 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Fatal Methemoglobinemia Due to Acute Inhalation of Methyl Nitrite in an Industrial Accident. J Forensic Sci. 2020;65(3):1016-1022. doi:10.1111\/1556-4029.14275","DOI":"10.1111\/1556-4029.14275"},{"key":"ref26","doi-asserted-by":"publisher","unstructured":"Wallace B, Doran N, Vincent C. Management of isopropyl nitrate-induced methaemoglobinaemia in pregnancy. BMJ Case Rep. 2024;17(7):e260357. doi:10.1136\/bcr-2024-260357","DOI":"10.1136\/bcr-2024-260357"},{"key":"ref27","doi-asserted-by":"publisher","unstructured":"Reisinger A, Vogt S, Essl A, Rauch I, Bangerl F, Eller P, et al. Lessons of the month 3: Intravenous poppers abuse: case report, management and possible complications. Clin Med (Lond). 2020;20(2):221-223. doi:10.7861\/clinmed.2019-0469","DOI":"10.7861\/clinmed.2019-0469"},{"key":"ref28","doi-asserted-by":"publisher","unstructured":"Runkle A, Block J, Haydar S. Man With Cyanosis and Altered Mental Status. Ann Emerg Med. 2020;75(1):18-48. doi:10.1016\/j.annemergmed.2020.01.028","DOI":"10.1016\/j.annemergmed.2020.01.028"},{"key":"ref29","doi-asserted-by":"publisher","unstructured":"Movio G, Erskine K, Scullion S. Methaemoglobinaemia due to alkyl nitrites in a patient with suspected traumatic injuries. BMJ Case Rep. 2023;16(5):e255131. doi:10.1136\/bcr-2023-255131","DOI":"10.1136\/bcr-2023-255131"},{"key":"ref30","doi-asserted-by":"publisher","unstructured":"Idries IY, Khristoforov V, Duddala S, Duong YV, Zaman M. Out of the Blue: Methemoglobinemia Associated With the Use of Amyl Nitrite in Rush Poppers for Erectile Stimulation. Cureus. 2023;15(6):e41201. doi:10.7759\/cureus.41201","DOI":"10.7759\/cureus.41201"},{"key":"ref31","doi-asserted-by":"publisher","unstructured":"Gooley B, Lofy T, Gross J, Sonnenberg T, Feldman R. Ventricular fibrillation in a 21-year-old after inhalation of an isobutyl nitrite \"popper\" product. Am J Emerg Med. 2023;64:204.e5-204.e7. doi:10.1016\/j.ajem.2022.10.048","DOI":"10.1016\/j.ajem.2022.10.048"},{"key":"ref32","doi-asserted-by":"publisher","unstructured":"Yoon JC, Kim SE. Suicide attempt using sodium nitrite ordered on the internet: Two case reports. Medicine (Baltimore). 2022;101(28):e29355. doi:10.1097\/MD.0000000000029355","DOI":"10.1097\/MD.0000000000029355"},{"key":"ref33","doi-asserted-by":"publisher","unstructured":"Zerbo S, Span\u00f2 M, Albano GD, Buscemi R, Malta G, Argo A. A fatal suicidal sodium nitrite ingestion determined six days after death. J Forensic Leg Med. 2023;98:102576. doi:10.1016\/j.jflm.2023.102576","DOI":"10.1016\/j.jflm.2023.102576"},{"key":"ref34","doi-asserted-by":"publisher","unstructured":"Dur\u00e3o C, Pedrosa F, Dinis-Oliveira RJ. A fatal case by a suicide kit containing sodium nitrite ordered on the internet. J Forensic Leg Med. 2020;73:101989. doi:10.1016\/j.jflm.2020.101989","DOI":"10.1016\/j.jflm.2020.101989"},{"key":"ref35","doi-asserted-by":"publisher","unstructured":"Dinis-Oliveira RJ, Dur\u00e3o C. When the antidote for cyanide poisonings becomes a nightmare: an alarming outbreak of suicides using kits containing sodium nitrite. Forensic Sci Res. 2023;8(2):170-171. doi:10.1093\/fsr\/owad015","DOI":"10.1093\/fsr\/owad015"},{"key":"ref36","doi-asserted-by":"publisher","unstructured":"Loiseau M, Matheux A, Sabini S, Cavard S, Advenier AS, Pasquet A, et al. Suicide of an adolescent girl with sodium nitrite ordered on the internet. J Forensic Sci. 2023;68(6):2200-2204. doi:10.1111\/1556-4029.15350","DOI":"10.1111\/1556-4029.15350"},{"key":"ref37","doi-asserted-by":"publisher","unstructured":"Saleh D, Lucyk S, McGillis E. Methemoglobinemia caused by sodium nitrite overdose. CMAJ. 2022;194(30):E1066-E1067. doi:10.1503\/cmaj.220434","DOI":"10.1503\/cmaj.220434"},{"key":"ref38","unstructured":"European Commission. Commission Regulation (EU) 2023\/2108 of 6 October 2023 amending Annex II to Regulation (EC) No 1333\/2008 of the European Parliament and of the Council and the Annex to Commission Regulation (EU) No 231\/2012 as regards food additives nitrites (E 249-250) and nitrates (E 251-252). Off J Eur Union. 2023;L260:1-18. Available from: https:\/\/eur-lex.europa.eu\/eli\/reg\/2023\/2108\/oj"},{"key":"ref39","doi-asserted-by":"publisher","unstructured":"Lee DY, Lee SY, Jo C, Yoon Y, Jeong JY, Hur SJ. Effect on health from consumption of meat and meat products. J Anim Sci Technol. 2021;63(5):955-976. doi:10.5187\/jast.2021.e101","DOI":"10.5187\/jast.2021.e101"},{"key":"ref40","doi-asserted-by":"publisher","unstructured":"Katabami K, Hayakawa M, Gando S. Severe Methemoglobinemia due to Sodium Nitrite Poisoning. Case Rep Emerg Med. 2016;2016:9013816. doi:10.1155\/2016\/9013816","DOI":"10.1155\/2016\/9013816"},{"key":"ref41","doi-asserted-by":"publisher","unstructured":"Ramtel R, Adhikari B, Shrestha M, Hirachan N, Poddar E, Shrestha S. Diagnosis and management of nitrobenzene poisoning in a low-resource setting: A case report. Ann Med Surg (Lond). 2022;81:104553. doi:10.1016\/j.amsu.2022.104553","DOI":"10.1016\/j.amsu.2022.104553"},{"key":"ref42","doi-asserted-by":"publisher","unstructured":"Timmons P. Seizures and severe methaemoglobinaemia following accidental ingestion of amyl nitrite. BMJ Case Rep. 2024;17(5):e259384. doi:10.1136\/bcr-2023-259384","DOI":"10.1136\/bcr-2023-259384"},{"key":"ref43","doi-asserted-by":"publisher","unstructured":"Kanji R, Schneider HJ, Pontin M. Brown-Colored Buccal Mucosa Associated with Methemoglobinemia. Cyanosis Appears Different in Varying Ethnic Groups. J Emerg Med. 2017;52(5):e209-e211. doi:10.1016\/j.jemermed.2016.11.033","DOI":"10.1016\/j.jemermed.2016.11.033"},{"key":"ref44","doi-asserted-by":"publisher","unstructured":"Wills BK, Cumpston KL, Downs JW, Rose SR. Causative Agents in Clinically Significant Methemoglobinemia: A National Poison Data System Study. Am J Ther. 2020;28(5):e548-e551. doi:10.1097\/MJT.0000000000001277","DOI":"10.1097\/MJT.0000000000001277"},{"key":"ref45","doi-asserted-by":"publisher","unstructured":"Hikin LJ, Ho J, Morley SR, Ahluwalia A, Smith PR. Sodium nitrite poisoning: A series of 20 fatalities in which post-mortem blood nitrite and nitrate concentrations are reported. Forensic Sci Int. 2023;345:111610. doi:10.1016\/j.forsciint.2023.111610","DOI":"10.1016\/j.forsciint.2023.111610"},{"key":"ref46","doi-asserted-by":"publisher","unstructured":"Matin AM, Boie ET, Moore GP. Survival after self-poisoning with sodium nitrite: A case report. J Am Coll Emerg Physicians Open. 2022;3(2):e12702. doi:10.1002\/emp2.12702","DOI":"10.1002\/emp2.12702"},{"key":"ref47","doi-asserted-by":"publisher","unstructured":"Garcia-Galindo CA, Pepin LC, Olives TD, Cole JB, Drone HM, Jones GA, et al. Massive Sodium Nitrite Overdose: A Case for Prehospital Methylene Blue. Prehosp Emerg Care. 2024;28(7):970-974. doi:10.1080\/10903127.2024.2357597","DOI":"10.1080\/10903127.2024.2357597"},{"key":"ref48","doi-asserted-by":"publisher","unstructured":"Mun SH, Park GJ, Lee JH, Kim YM, Chai HS, Kim SC. Two cases of fatal methemoglobinemia caused by self-poisoning with sodium nitrite: A case report. Medicine (Baltimore). 2022;101(7):e28810. doi:10.1097\/MD.0000000000028810","DOI":"10.1097\/MD.0000000000028810"},{"key":"ref49","unstructured":"Lindenmann J, Fink-Neuboeck N, Schilcher G, Smolle-Juettner FM. Severe methaemoglobinaemia treated with adjunctive hyperbaric oxygenation. Diving Hyperb Med. 2015;45(2):132-134."},{"key":"ref50","doi-asserted-by":"publisher","unstructured":"He J, Liu W, Ren X, Ding D, He L, Zhang Y, et al. Degradation and preservation of nitrites in whole blood. Forensic Sci Int. 2024;364:112232. doi:10.1016\/j.forsciint.2024.112232","DOI":"10.1016\/j.forsciint.2024.112232"},{"key":"ref51","doi-asserted-by":"publisher","unstructured":"Bugelli V, Tarozzi I, Manetti AC, Stefanelli F, Di Paolo M, Chericoni S. Four cases of sodium nitrite suicidal ingestion: A new trend and a relevant Forensic Pathology and Toxicology challenge. Leg Med (Tokyo). 2022;59:102146. doi:10.1016\/j.legalmed.2022.102146","DOI":"10.1016\/j.legalmed.2022.102146"},{"key":"ref52","doi-asserted-by":"publisher","unstructured":"Perkins CJ, Wahl GE, Gillett MJ. A case of pseudohyperchloraemia caused by sodium nitrate ingestion. Clin Toxicol (Phila). 2022;60(2):259-261. doi:10.1080\/15563650.2021.1939882","DOI":"10.1080\/15563650.2021.1939882"},{"key":"ref53","doi-asserted-by":"publisher","unstructured":"Zhang M, Truver MT, Hoyer JL, Chronister CW, Goldberger BA. Presumptive identification of nitrite by Griess reagent test strips-Case reports of fatal poisoning with sodium nitrite. J Anal Toxicol. 2023;47(8):746-749. doi:10.1093\/jat\/bkad038","DOI":"10.1093\/jat\/bkad038"},{"key":"ref54","doi-asserted-by":"publisher","unstructured":"Tomsia M, G\u0142az M, Nowicka J, Szczepa\u0144ski M. Sodium nitrite detection in costal cartilage and vitreous humor - Case report of fatal poisoning with sodium nitrite. J Forensic Leg Med. 2021;81:102186. doi:10.1016\/j.jflm.2021.102186","DOI":"10.1016\/j.jflm.2021.102186"},{"key":"ref55","doi-asserted-by":"publisher","unstructured":"Andelhofs D, Van Den Bogaert W, Lepla B, Croes K, Van de Voorde W. 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Forensic Sci Int. 2022;335:111279. doi:10.1016\/j.forsciint.2022.111279","DOI":"10.1016\/j.forsciint.2022.111279"},{"key":"ref58","doi-asserted-by":"publisher","unstructured":"Bickler MP, Rhodes LJ. Accuracy of detection of carboxyhemoglobin and methemoglobin in human and bovine blood with an inexpensive, pocket-size infrared scanner. 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