Minimum ingested iron cut-off triggering serious iron toxicity in children.

Area of Science:

• Pediatric Toxicology
• Emergency Medicine

Background:

• Iron intoxication is a significant concern in children, arising from accidental ingestion or intentional overdose.
• Symptoms range widely, often including gastrointestinal distress like vomiting and diarrhea.
• Previous studies identified various toxic iron doses but lacked a specific minimum threshold for severe outcomes.

Purpose of the Study:

• To examine the demographic characteristics of iron intoxication in Turkish children.
• To establish the lowest ingested elemental iron dose that indicates serious toxicity and necessitates prompt management.

Main Methods:

• A retrospective analysis was conducted on 83 Turkish pediatric patients presenting with acute iron poisoning.
• Data included accidental versus intentional ingestion, ingested iron dosage, and serum iron levels.

Main Results:

• Accidental iron ingestion was more prevalent than intentional cases among the 83 patients.
• A median ingested dose of 40.0 mg/kg (IQR, 33.5 mg/kg) was observed in 53 patients.
• The median serum iron concentration within 6 hours was 150 μg/dL (IQR, 282 μg/dL), with 20 patients receiving deferoxamine.

Conclusions:

• The critical threshold for ingested elemental iron triggering severe toxicity and requiring deferoxamine in children under 18 is 28 mg/kg.
• This finding aids in early risk assessment and timely intervention for pediatric iron poisoning.