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Infantile iron poisoning: challenges in diagnosis and management

Kevin Valentine1, Christopher Mastropietro, Ashok P Sarnaik

  • 1Department of Pediatrics, Wayne State University School of Medicine and Children's Hospital of Michigan, Detroit, MI, USA. kvalenti@med.wayne.edu

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|May 13, 2009
PubMed

Insights

Accidental iron poisoning in a premature infant led to metabolic acidosis and shock. Prompt treatment with inotropes and deferoxamine (iron chelator) resulted in full recovery, highlighting unique challenges in neonates.

Area of Science:

  • Pediatric Toxicology
  • Neonatal Critical Care

Background:

  • Iron poisoning is a significant concern in pediatric populations.
  • Neonatal iron poisoning presents unique challenges due to immature organ systems.

Observation:

  • A 7-week-old, ex-28-week premature infant accidentally ingested ferrous sulfate.
  • The infant developed severe metabolic acidosis and shock.

Findings:

  • Complete recovery was achieved with inotropic support and deferoxamine chelation therapy.
  • This case represents the youngest infant reported with iron poisoning causing metabolic acidosis and shock.
  • Physiologic immaturity complicated the management and recovery process.

Implications:

  • Iron poisoning should be considered in the differential diagnosis of neonatal shock of unknown origin.
  • Specialized diagnostic and therapeutic approaches are crucial for managing iron poisoning in young infants.
Abstract

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