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

Halit Halil1, Nilden Tuygun1, Emine Polat2

  • 1Pediatric Emergency Service, Dr Sami Ulus Maternity and Children's Research and Training Hospital, University of Health Sciences, Ankara, Turkey.

Pediatrics International : Official Journal of the Japan Pediatric Society
|March 19, 2019
PubMed

Insights

A key finding in pediatric iron poisoning is that ingesting 28 mg/kg of elemental iron can trigger severe toxicity. This threshold is crucial for identifying children needing immediate medical intervention for acute iron intoxication.

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.
Abstract

Keywords:
childrencut-offironpoisoning

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