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[Iron intoxication--poisoning with easily accessible medicines]
Lakartidningen
|January 22, 2015
Summary
A young woman experienced severe iron poisoning from ferrous sulfate overdose. Despite prompt treatment with deferoxamine and supportive care, she developed multi-organ failure and died.
Area of Science:
- Toxicology
- Emergency Medicine
- Pharmacology
Background:
- Iron poisoning is a significant cause of morbidity and mortality, particularly in young adults.
- Ferrous sulfate is a common medication implicated in accidental and intentional overdoses.
Observation:
- A 20-year-old woman presented with altered mental status and signs of shock following a large ferrous sulfate ingestion (160 mg/kg).
- Initial management included deferoxamine, intubation, and whole bowel irrigation.
- Delayed serum iron measurement revealed severe iron overload (131 µmol/l at 15 hours post-ingestion).
Findings:
- The patient developed circulatory instability, hepatic failure, coagulopathy, and renal insufficiency.
- Despite intensive care and continuous renal replacement therapy, the patient succumbed to iron toxicity.
Implications:
- This case highlights the critical importance of early diagnosis and aggressive management in severe iron poisoning.
- Prompt and accurate monitoring of serum iron levels is crucial for guiding treatment decisions.
- Severe iron toxicity can lead to multi-organ failure and death, even with comprehensive medical intervention.