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Fatal transcutaneous iron intoxication.

D E Chang1, D E Bruns, D A Spyker

  • 1Georgetown University School of Medicine, Washington, DC.

The Journal of Burn Care & Rehabilitation
|July 1, 1988
PubMed
Summary
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Accidental iron poisoning is a serious risk for children. This report details the first fatal iron intoxication case solely due to skin absorption through burns, mimicking oral poisoning symptoms.

Area of Science:

  • Toxicology
  • Dermatology
  • Emergency Medicine

Background:

  • Accidental iron intoxication is a leading cause of poisoning in young children.
  • Adult iron intoxication is rare, typically linked to intentional self-harm or homicide.
  • Previous cases involved oral ingestion of iron salts, with rare instances of aspiration or dermal absorption.

Observation:

  • This report presents the first documented case of fatal iron intoxication where the primary route of absorption was through burned skin.
  • The patient experienced severe chemical burns, leading to significant dermal absorption of ferrous chloride.
  • The clinical presentation was consistent with acute oral iron intoxication.

Findings:

  • The patient developed refractory acidosis, a critical metabolic disturbance.

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  • Disseminated intravascular coagulation (DIC) occurred, indicating widespread clotting abnormalities.
  • Progressive respiratory and renal failure, along with sepsis, contributed to the fatal outcome.
  • Implications:

    • Highlights the potential for severe systemic toxicity from dermal iron absorption, even without ingestion.
    • Underscores the need for recognizing skin exposure as a significant route for iron poisoning.
    • Emphasizes the critical importance of immediate decontamination and supportive care in cases of extensive skin exposure to iron compounds.