Gastrointestinal Pathology in Adult Iron Overdose

Abstract

The gastrointestinal effects of iron overdose have been described in children. They may occur acutely, ranging in severity from mucosal injury to complete infarction, or several weeks later, as obstruction due to stricture formation. They typically occur in the stomach or proximal small bowel. We describe an adult example of both, each occurring in the distal portion of the small intestine. Both patients had ingested enteric-coated iron preparations and both experienced significant, protracted abdominal pain. Thus adults as well as children are at risk for severe gastrointestinal complications after iron overdose. Significant protracted abdominal pain should alert the clinician of its possibility. Damage to distal areas of the bowel can occur with complete sparing of proximal portions particularly if the iron is an enteric-coated preparation.

Suppression of SLC11A2 Expression Is Essential to Maintain Duodenal Integrity During Dietary Iron Overload

“…40 This poisoning can cause bloody diarrhea and vomiting due to the damage of the intestinal epithelial linings. 41,42 Erosive injury to the upper gastrointestinal tract in patients receiving iron medication has been reported as a side effect. 43 In the present experiments, ferric citrate was easily absorbed, leading to extremely high levels of iron in the liver both in TGs and wild-type mice.…”

Effect of Iron Succinyl-Protein Complexes on Gastrointestinal Motility in the Fasting Dog

“…It has been shown that the histolesive action of some agents on the gastrointestinal tract is aggra vated by the simultaneous induction of con tractions [14]. Thus, the ferrous sulfate-in-duced alterations in motor activity demon strated in the present study may contribute to the histological damage observed in iron overdose [15].…”

Iron-induced gastric ulceration with radiological and endoscopic appearance of carcinoma

“…Erosive injury to the mucosa of the upper GI tract is well known in the context of overdoses of oral iron supplements 1 2. However, such injury in the context of therapeutic dosing is less well recognised.…”

“…While erosive injury to the mucosa of the upper gastrointestinal (GI) tract is a well-recognised consequence of overdose with oral iron supplements,1 2 similar injuries can result from doses in the normal therapeutic range. In this case, the associated endoscopic and radiological features were highly suggestive of malignancy—a presentation that has not previously been reported.…”