Iron Poisoning A toxic condition caused by excessive iron intake, primarily from supplements or accidental overdose. Common in children due to accidental ingestion of iron-containing medications.
Causes of Iron Poisoning - Accidental overdose (children consuming iron supplements) - Intentional overdose (suicide attempts) - Chronic excessive intake (hemochromatosis, repeated transfusions)
Pathophysiology - Excess iron leads to oxidative stress and free radical production. - Direct damage to gastrointestinal tract and systemic toxicity. - Affects liver, heart, and metabolic processes.
Symptoms of Iron Poisoning Stages of Toxicity: 1. Stage 1 (0-6 hours): Nausea, vomiting, diarrhea, abdominal pain, GI bleeding. 2. Stage 2 (6-24 hours): Temporary improvement. 3. Stage 3 (12-48 hours): Shock, metabolic acidosis, liver failure, coagulopathy. 4. Stage 4 (2-5 days): Liver necrosis, organ failure. 5. Stage 5 (2-6 weeks): GI scarring, strictures.
Diagnosis - Clinical history & symptoms - Serum iron levels (Toxic level: > 350 mcg/dL) - Total iron-binding capacity (TIBC) - Abdominal X-ray (for visible iron tablets) - Blood gas analysis (metabolic acidosis)
Treatment - Initial Management: - Gastric lavage (if ingestion within 1-2 hours) - Activated charcoal *not effective* for iron poisoning - Supportive Care: - IV fluids, electrolyte correction, monitoring vitals - Chelation Therapy: - Deferoxamine (IV) for severe cases - Indicated if serum iron >500 mcg/dL or systemic toxicity present - Hemodialysis: - If severe toxicity with renal failure
Prevention - Childproof packaging of iron supplements - Education on medication storage - Screening for hereditary hemochromatosis - Careful dosing of iron supplements
Conclusion - Iron poisoning is a medical emergency requiring rapid intervention. - Early recognition and treatment significantly improve outcomes. - Prevention is key in reducing accidental iron overdose cases.
References - Medical guidelines and textbooks on toxicology - Recent journal articles on iron toxicity and treatment