Toxicity in Humans
Due to its oxidative nature, sodium chlorate can be very toxic if ingested. The oxidative effect on hemoglobin leads to methaemoglobin formation, which is followed by denaturation of the globin protein and a cross-linking of erythrocyte membrane proteins with resultant damage to the membrane enzymes. This leads to increased permeability of the membrane, and severe hemolysis. The denaturation of hemoglobin overwhelms the capacity of the G6PD metabolic pathway. In addition, this enzyme is directly denatured by chlorate reducing its activity.
Therapy with ascorbic acid and methylene blue are frequently used in the treatment of methemoglobinemia. However, since methylene blue requires the presence of NADPH that requires normal functioning of G6PD system, it is less effective than in other conditions characterized by hemoglobin oxidation.
Acute severe hemolysis results, with multi-organ failure, including DIC and renal failure. In addition there is a direct toxicity to the proximal renal tubule. The treatment will consist of exchange transfusion, peritoneal dialysis or hemodialysis.
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