Near fatal iron intoxication managed conservatively

Sankar, Jhuma; Shukla, Amelin; Khurana, Rohit; Dubey, Nand Kishore

doi:10.1136/bcr-2012-007670

Cited by 11 publications

(4 citation statements)

References 9 publications

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“…The blood iron level was found to be 350 mcg/dl in that patient. There are few case reports about using deferoxamine in patients aged under 3 years (10,11). No adverse effects were seen with deferoxamine in any of our patients, including the 25-month-old infant.…”

Section: Resultsmentioning

confidence: 93%

Acute Iron Poisoning in Children: An Ongoing Important Pediatric Emergency

Açoğlu¹,

Akçaboy²,

OĞUZ³

et al. 2018

Turkish J Pediatr Dis

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Objective: Iron containing drugs are one of the most commonly prescribed drugs in our country and accidental or suicidal poisoning continues to be an important pediatric emergency. Our aim was to evaluate the clinical, laboratory, radiologic findings, and treatment approaches of children hospitalized with acute iron poisoning. Material and Methods:The clinical, laboratory, and radiologic findings of and treatment approaches for 17 patients aged 14 months-15 years hospitalized with acute iron poisoning were reviewed. results:The mean age was 37±35.2 months. Iron poisoning was accidental in 16 patients. The mean duration between drug intake and hospital admission was 177±149 minutes. The mean ingested amount of iron was 35.4±19 mg/kg. The mean blood iron level was 232±136 mcg/dl. There was no significant relationship between the reported dose of ingested iron and the blood iron level (p>0.05). There was no significant relationship between blood iron level and ingestion time (p>0.05). Laboratory results revealed metabolic acidosis in 3 patients, respiratory acidosis in one patient, leucocytosis in one patient, and prolonged activated partial thromboplastin time in one patient. The patients' findings were not consistent with blood iron levels. Whole bowel irrigation and IV deferoxamine were used in 3 patients. There was no death. The mean hospitalization duration was 2.8±1.1 days.conclusion: Accidental iron poisoning continues to be an important pediatric emergency. There are no correlations between blood iron levels and the amount of ingested iron or the ingestion time. There was also no correlation between the blood iron levels and the clinical, laboratory and radiographic findings in our study.Key Words: Iron, Fe+2, Fe+3, Poisoning ÖzET Amaç: Demir içeren ilaçlar ülkemizde en sık reçete edilen ilaçlardandır. Dolayısıyla kaza ya da suisidal zehirlenmeler önemli bir pediatrik acil olmaya devam etmektedir. Amacımız, akut demir zehirlenmesi ile hastaneye yatırılan çocukların klinik, laboratuvar, radyolojik bulgularını ve tedavi yaklaşımlarını değerlendirmektir. Gereç ve Yöntemler:Akut demir zehirlenmesi nedeniyle hastaneye yatırılan 14 ay-15 yaş arası 17 hastanın klinik, laboratuvar, radyolojik bulguları ve tedavi yaklaşımları incelendi. bulgular: Ortalama yaş 37±35.2 aydı. Demir zehirlenmesi 16 hastada kazara gerçekleşmişti. İlaç alımı ile hastaneye başvuru arasındaki süre 177±149 dakikaydı. Ortalama alınan demir miktarı 35.4±19 mg/kg'dı. Ortalama kan demir düzeyi 232±136 mcg/dl'di. Alındığı söylenen doz ile kan demir düzeyi arasında anlamlı ilişki yoktu. (p>0.05). Kan demir düzeyi ile ilaç alma zamanı arasında da anlamlı ilişki yoktu (p>0.05). Laboratuvar incelemede; 3 hastada metabolik asidoz, 1 hastada respiratuar asidoz, 1 hastada lökositoz ve 1 hastada da uzamış aktive parsiyel tromboplastin zamanı (aPTT) görüldü. Hastaların bulguları ile kan demir düzeyleri uyumlu değildi. Tüm bağırsak yıkama ve IV desferrioxamine 3 hastada uygulandı. Ölüm olmadı. Ortalama hastanede kalım süresi 2.8±1.1 gündü.sonuç: Ka...

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Section: Resultsmentioning

confidence: 93%

Acute Iron Poisoning in Children: An Ongoing Important Pediatric Emergency

Açoğlu¹,

Akçaboy²,

OĞUZ³

et al. 2018

Turkish J Pediatr Dis

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“…Iron poisoning has four clinical stages. 5 Features of acute gastrointestinal irritation dominate the period up to 6 hours after ingestion, and most patients do not develop other features or progress beyond this stage. Hypotension may arise at this stage either due to hypovolemia due to continuous vomiting or due to blood loss due to gastric erosion.…”

Section: Discussionmentioning

confidence: 99%

Non-suicidal intentional ingestion of iron tablets and severe intoxication: the result of adolescent boy’s impulsive risky behaviour in the school

Tandon

Khandwala

et al. 2021

Int J Contemp Pediatr

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Acute iron poisoning is a potentially fatal intoxication in children. As the Iron preparations are commonly administered to pregnant women, lactating mothers, toddlers, it is easily available at home. So younger children are prone to consume it accidently. Although iron is a therapeutic drug in recommended dosages, excessive iron in the free state can produce toxicity by affecting multiple cellular processes by catalysing redox reactions with lipid peroxidation and free radical formation. The severity of intoxication depends on the amount of elemental iron ingested. Serious toxicity is usually associated with a dose of >40 mg/kg of elemental iron. Levels more than 100 mg/kg are almost always fatal. We report a case where a 12-year male child intentionally taken 60 tablets of iron (ferrous fumarate) at his school as a part of competition or bet to other schoolmate and presented with acute iron poisoning with hepatic encephalopathy to us. Important initial laboratory parameters were AST-4,879 U/L, Prothrombin time-60 sec and Iron level-213 microgram/dl. With timely specific management i.e., deferoxamine infusion along with all required intensive care supportive management in PICU the patient was discharged successfully. We chose to report this case to highlight the risky behaviour of adolescence who usually grows physically and emotionally earlier but their prefrontal lobes are yet immature to take proper and correct decision. Thus, impulse activity may prove fatal for them.

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“…Deferoxamín viaže nadbytočné železo v tele, pričom sa vytvorí zlúčenina nazývaná chelát, ktorú je telo schopné vylúčiť a tým bráni poškodeniu orgánov spôsobených nadbytkom železa. (15) Nežiaduce účinky intravenóznej liečby deferoxamínom zahŕňajú hypotenziu a rozvoj syndrómu akútnej respiračnej tiesne. (10) Po začatí liečby sa vytvorením komplexu železa s deferoxamínom moč pacientky sfarbil do ružova, čo môže potvrdiť účinnosť podávaného lieku.…”

Section: Diskusiaunclassified