What are the documented case reports of sodium chlorite/MMS poisoning and their outcomes?

1. Scope and sources of documented cases: what’s been reported

The literature includes individual case reports dating back decades and aggregated poison-center data through 2020; peer‑reviewed case series and toxicology reviews synthesize these reports and list at least a handful of well-documented human intoxications from sodium chlorite or chlorine dioxide preparations marketed as MMS ^{[1] [6] [4]}. Poison-control narratives analyzed by clinicians cover dozens of exposures with known outcomes across U.S. centers from 2000–2020, while isolated but detailed case reports describe more fulminant presentations requiring dialysis, transfusion and advanced support ^{[4] [6] [1]}.

2. Typical clinical features described in the reports

Across case reports the predominant acute manifestations are methemoglobinemia (often visible as “dark chocolate” blood and cyanosis), oxidative hemolysis causing anemia and dark urine, and acute renal failure that may require renal replacement therapy; gastrointestinal symptoms such as vomiting and diarrhea are also frequently reported ^{[2] [7] [1]}. Toxicology reviews and case series emphasize that these effects are pathophysiologically linked to the strong oxidant properties of chlorite/chlorine dioxide on erythrocytes and renal tissue ^{[5] [1]}.

3. Notable pediatric and severe cases and outcomes

Several high‑profile pediatric cases involved accidental ingestion of concentrated sodium chlorite: siblings aged 8–9 were reported with one child experiencing severe methemoglobinemia, renal failure and hemolysis needing prolonged hospitalization while the other had milder symptoms and recovered ^{[8] [9]}. Adult cases include suicide attempts or large accidental ingestions that produced anuric renal failure, disseminated intravascular coagulation and protracted recovery—some required weeks of dialysis before renal function normalized and others needed red cell transfusion or exchange ^{[3] [6] [1]}.

4. Treatments used and documented outcomes

Management in reports has centered on methylene blue for methemoglobinemia, supportive transfusions or red‑cell exchange for hemolysis, and renal replacement therapy for acute kidney injury; several case reports detail successful recovery using combinations of these interventions, although the literature notes methylene blue can be less effective or complicated in chlorite poisoning because erythrocyte enzymatic systems may be denatured ^{[1] [6]}. Outcomes vary: many patients ultimately recovered renal function over weeks to months with intensive care, while some cases were life‑threatening and at least one series reports a fatality linked to intentional ingestion during the COVID-19 pandemic ^{[3] [8] [1]}.

5. How common and how well captured are these events?

Surveillance is incomplete: poison‑center data provide a partial view and likely undercount exposures and long‑term sequelae because centers primarily capture acute calls and some reports exclude non‑MMS sodium chlorite products ^[4]. Toxicology reviews therefore caution that reported cases probably represent a subset of actual exposures and that the true incidence—especially of milder or unreported poisonings—is uncertain ^[4].

6. Regulatory response and the role of misinformation

Regulatory bodies including the U.S. FDA and public‑health agencies have issued warnings about MMS after internet promotion as a “cure‑all,” and enforcement actions and advisories followed rising adverse‑event reports; scientific reviews document that MMS is an industrial‑strength oxidant with no proven therapeutic benefit and substantial risk when ingested ^{[4] [10] [11]}. The reporting makes explicit the interplay between online promotion (e.g., Genesis II/advocates), pandemic-era misinformation spikes, and consequent toxic exposures documented in multiple countries ^{[11] [8]}.

7. Limitations in the available reporting and final assessment

The published record is dominated by case reports and poison‑center summaries rather than large controlled studies, so quantifying population risk, long‑term outcomes, and the full clinical spectrum is limited; where sources do not provide long‑term follow‑up or comprehensive epidemiology, this analysis refrains from asserting unknowns as fact ^{[4] [1]}. Taken together, however, the documented cases consistently demonstrate that concentrated sodium chlorite/MMS ingestion can cause severe oxidant-mediated hematologic and renal injury with outcomes from recovery after intensive treatment to prolonged morbidity and occasional death ^{[1] [2] [3]}.