Iron poisoning
Pro Research Analysisby 
Searched over 200M research papers for "iron poisoning"
Iron Poisoning: Causes, Symptoms, and Management
Introduction to Iron Poisoning
Iron poisoning is a significant toxicological issue, particularly affecting the gastrointestinal and circulatory systems. Iron, while essential for various bodily functions such as oxygen transport and DNA synthesis, can become highly toxic when ingested in large quantities . This article explores the causes, symptoms, and management strategies for iron poisoning, with a focus on both pediatric and adult cases.
Causes of Iron Poisoning
Accidental Ingestion in Children
Iron overdose is the leading cause of poisoning deaths in children. This is often due to the accidental ingestion of iron-containing compounds, which are readily available, brightly colored, and sometimes mistaken for harmless vitamins by parents .
Intentional Overdose in Adults
In adults, iron poisoning typically results from the intentional ingestion of large amounts of iron supplements, often in suicide attempts. Excessive iron intake leads to a caustic effect on the gastrointestinal tract, causing massive iron absorption and subsequent toxicity .
Symptoms and Clinical Presentation
Initial Symptoms
The toxicity of iron poisoning begins to manifest with an intake of 20 mg/kg of elemental iron, presenting initial symptoms such as nausea, vomiting, and gastrointestinal distress .
Severe Symptoms
As the condition progresses, more severe symptoms can develop, including metabolic acidosis, respiratory distress, and mental disorders ranging up to coma . In extreme cases, patients may experience circulatory shock, multi-organ failure, and disseminated intravascular coagulation.
Clinical Phases
Iron poisoning typically progresses through five distinct clinical phases:
- Gastrointestinal Toxicity
- Relative Stability
- Circulatory Shock and Acidosis
- Hepatotoxicity
- Gastrointestinal Scarring.
Diagnosis and Management
Initial Assessment
The initial management of iron poisoning involves an ABC (Airway, Breathing, Circulation) evaluation, obtaining vascular access, and monitoring the patient. Oxygen support and endotracheal intubation may be necessary for lethargic patients to secure the airway and prevent aspiration.
Diagnostic Tests
For patients with severe symptoms, a series of diagnostic tests should be conducted, including hemogram, serum iron levels, kidney and liver function tests, serum electrolytes, coagulation panel, and blood gas analysis .
Treatment Strategies
Decontamination
Early decontamination through abdominal and intestinal lavage is crucial. This helps to remove any remaining iron tablets from the gastrointestinal tract .
Chelation Therapy
Chelation therapy with deferoxamine is the cornerstone of treatment for severe iron poisoning. This therapy helps to bind the excess iron, facilitating its excretion from the body . Intravenous deferoxamine is particularly indicated in cases of severe intoxication, along with supportive care to maintain intravascular volume and correct acidosis and coagulation disorders.
Advanced Interventions
In rare cases where large numbers of iron tablets are present in the gastrointestinal tract, surgical removal may be necessary. Hemodialysis and exchange transfusion are reserved for cases where more conservative treatments fail.
Conclusion
Iron poisoning remains a critical medical emergency, particularly in pediatric populations. Prompt recognition and appropriate management are essential to reduce morbidity and mortality. Understanding the toxicokinetics and toxicodynamics of iron, along with timely intervention strategies such as chelation therapy, can significantly improve patient outcomes.
Sources and full results
Most relevant research papers on this topic