Iron poisoning

Fine, Jeffrey

doi:10.1067/mps.2000.104055

Cited by 37 publications

(13 citation statements)

References 118 publications

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“…6,8,13 In addition to chronic iron-induced cardiomyopathy, acute iron toxicosis is also associated with myocardial injury and dysfunction. 14,15 Therefore, the phenotypic diversity of iron-overload cardiomyopathy range from acute toxic effects of iron to chronic iron-mediated effects (increased interstitial fibrosis with inflammatory changes). In our murine model, we made a distinction between direct toxic effects of iron on the heart (subacute protocol) versus chronic iron-mediated myocardial damage (chronic protocol).…”

Section: Discussionmentioning

confidence: 99%

“…6,8,13 Acute iron toxicosis, a common cause of pediatric drug-related mortality, is also associated with myocardial injury and dysfunction. 14,15 Iron overload is associated with increased free radical production and elevated oxidative stress and altered intracellular Ca 2ϩ handling in cardiomyocytes. 16 -21 As such, therapeutic strategies that attempt to minimize the oxidative damage and reduce perturbations in intracellular Ca 2ϩ may protect the cardiovascular system from iron-mediated injury.…”

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confidence: 99%

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Taurine Supplementation Reduces Oxidative Stress and Improves Cardiovascular Function in an Iron-Overload Murine Model

et al. 2004

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Background-Iron overload has an increasing worldwide prevalence and is associated with significant cardiovascular morbidity and mortality. Elevated iron levels in the myocardium lead to impaired systolic and diastolic function and elevated oxidative stress. Taurine accounts for 25% to 50% of the amino acid pool in myocardium, possesses antioxidant properties, and can inhibit L-type Ca 2ϩ channels. Thus, we hypothesized that this agent would reduce the cardiovascular effects of iron overload. Methods and Results-Iron-overloaded mice were generated by intraperitoneal injection of iron either chronically (5 days per week for 13 weeks) or subacutely (5 days per week for 4 weeks). Iron overload causes increased mortality, elevated oxidative stress, systolic and diastolic dysfunction, hypotension, and bradycardia. Taurine supplementation increased myocardial taurine levels by 45% and led to reductions in mortality and improved cardiac function, heart rate, and blood pressure in iron-overloaded mice. Histological examination of the myocardium revealed reduced apoptosis and interstitial fibrosis in iron-overloaded mice supplemented with taurine. Taurine mediated reduced oxidative stress in iron-overloaded mice along with attenuation of myocardial lipid peroxidation and protection of reduced glutathione level. Conclusions-These results demonstrate that treatment with taurine reduces iron-mediated myocardial oxidative stress, preserves cardiovascular function, and improves survival in iron-overloaded mice. The role of taurine in protecting reduced glutathione levels provides an important mechanism by which oxidative stress-induced myocardial damage can be curtailed. Taurine, as a dietary supplement, represents a potential new therapeutic agent to reduce the cardiovascular burden from iron-overload conditions.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Taurine Supplementation Reduces Oxidative Stress and Improves Cardiovascular Function in an Iron-Overload Murine Model

et al. 2004

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“…However, in severe cases, this resolution of symptoms might not be observed (5). The first phase, which occurs within a few hours after ingestion, results from the corrosive effects of iron on the gastrointestinal tract and is characterized by vomiting and diarrhea, both of which can become bloody and severe.…”

Section: Syndrome Of Iron Poisoningmentioning

confidence: 99%

Iron Ingestion: an Evidence-Based Consensus Guideline for Out-of-Hospital Management

Wax

Erdman

Chyka

et al. 2005

Clinical Toxicology

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From 1983 to 1991, iron caused over 30% of the deaths from accidental ingestion of drug products by children. An evidence-based expert consensus process was used to create this guideline. Relevant articles were abstracted by a trained physician researcher. The first draft of the guideline was created by the primary author. The entire panel discussed and refined the guideline before its distribution to secondary reviewers for comment. The panel then made changes in response to comments received. The objective of this guideline is to assist poison center personnel in the appropriate out-of-hospital triage and initial management of patients with suspected ingestions of iron by 1) describing the manner in which an ingestion of iron might be managed, 2) identifying the key decision elements in managing cases of iron ingestion, 3) providing clear and practical recommendations that reflect the current state of knowledge, and 4) identifying needs for research. This guideline applies to ingestion of iron alone and is based on an assessment of current scientific and clinical information. The expert consensus panel recognizes that specific patient care decisions may be at variance with this guideline and are the prerogative of the patient and the health professionals providing care, considering all of the circumstances involved. The panel's recommendations follow; the grade of recommendation is in parentheses. 1) Patients with stated or suspected self-harm or who are victims of malicious administration of an iron product should be referred to an acute care medical facility immediately. This activity should be guided by local poison center procedures. In general, this should occur regardless of the amount ingested (Grade D). 2) Pediatric or adult patients with a known ingestion of 40 mg/kg or greater of elemental iron in the form of adult ferrous salt formulations or who have severe or persistent symptoms related to iron ingestion should be referred to a healthcare facility for medical evaluation. Patients who have ingested less than 40 mg/kg of elemental iron and who are having mild symptoms can be observed at home. Mild symptoms such as vomiting and diarrhea occur frequently. These mild symptoms should not necessarily prompt referral to a healthcare facility. Patients with more serious symptoms, such as persistent vomiting and diarrhea, alterations in level of consciousness, hematemesis, and bloody diarrhea require referral. The same dose threshold should be used for pregnant women, however, when calculating the mg/kg dose ingested, the pre-pregnancy weight of the woman should be used (Grade C). 3) Patients with ingestions of children's chewable vitamins plus iron should be observed at home with appropriate follow-up. The presence of diarrhea should not be the sole indicator for referral as these products are often sweetened with sorbitol. Children may need referral for the management of dehydration if vomiting or diarrhea is severe or prolonged (Grade C). 4) Patients with unintentional ingestions of carbonyl iron or polys...

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“…The first stage presents with predominately gastrointestinal symptoms within 6 hours after ingestion. 4 The fourth stage is the period of clinical recovery, and the fifth stage is the development of gastrointestinal strictures, which may follow the first 4 stages within 2 to 8 weeks. During the second stage of iron toxicity, also known as the latent stage, symptoms are continued metabolic acidosis, mild hyperventilation, and oliguria.…”

Section: Discussionmentioning

confidence: 99%

Child Abuse by Intentional Iron Poisoning Presenting as Shock and Persistent Acidosis

Black

Zenel

2003

Pediatrics

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Iron poisoning

Cited by 37 publications

References 118 publications

Taurine Supplementation Reduces Oxidative Stress and Improves Cardiovascular Function in an Iron-Overload Murine Model

Taurine Supplementation Reduces Oxidative Stress and Improves Cardiovascular Function in an Iron-Overload Murine Model

Iron Ingestion: an Evidence-Based Consensus Guideline for Out-of-Hospital Management

Child Abuse by Intentional Iron Poisoning Presenting as Shock and Persistent Acidosis

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