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Near fatal iron intoxication managed conservatively

Jhuma Sankar1, Amelin Shukla, Rohit Khurana

  • 1Department of Pediatrics, PGIMER, Dr RML Hospital, New Delhi, India. jhumasankar@gmail.com

BMJ Case Reports
|February 5, 2013
PubMed

Insights

A pediatric case of severe elemental iron poisoning in an infant showed remarkable recovery with conservative medical management alone, avoiding the need for exchange transfusion despite critically high iron levels.

Area of Science:

  • Pediatric Toxicology
  • Emergency Medicine
  • Clinical Case Reports

Background:

  • Elemental iron ingestion is a common cause of poisoning in children, potentially leading to severe toxicity.
  • Prompt recognition and management are crucial for favorable outcomes in pediatric iron overdose cases.

Observation:

  • An infant presented with symptoms of severe iron toxicity, including hypotension, metabolic acidosis, and irritability, following unintentional ingestion of approximately 130 mg/kg of elemental iron.
  • Serum iron levels were significantly elevated at 360 µg/dl, indicating substantial iron absorption and systemic toxicity.

Findings:

  • The infant experienced an uneventful recovery solely through conservative medical management.
  • Exchange transfusion, a potentially invasive procedure, was not required despite the high degree of iron toxicity.

Implications:

  • This case underscores the potential efficacy of conservative management in pediatric elemental iron poisoning.
  • Highlighting successful outcomes with medical management alone may guide treatment strategies and reduce the need for more aggressive interventions in similar cases.

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