[A case of remarkable bronchial stenosis due to aspiration of delayed-release iron tablet]

This report describes a rare case of bronchial mucosal injury caused by aspiration of a delayed-iron tablet. A 44-year-old woman had been taking delayed-iron tablets (Feto-Gradumet) regularly because of iron deficiency anemia, and accidentally aspirated a tablet into her bronchus. After this accident, she had complained of wheezing and shortness of breath. On bronchoscopy, the bronchial mucosa of left lower lobe initially showed remarkable swelling and redness, and became corroded and narrowed gradually by iron toxicity over several months, although we tried to remove some fragments of tablet as completely as possible. While we had examined her bronchi repeatedly by bronchoscopy, the bronchial mucosa gradually normalized during 15 months, but moderate stenosis of the left basal bronchus remained. The pathological findings showed infiltration of inflammatory cells, edema and granuloma formation in the submucosal region. This report suggests that the bronchial injury was due to the toxicity of persistent ferrous sulfate eluted from the iron tablet which had adhered firmly to the wet bronchial wall for a long time.