Fulminant Hepatic Failure Following Intentional Iron Overdose-A Case Report

Area of Science:

• Toxicology
• Internal Medicine
• Emergency Medicine

Background:

• Intentional iron overdose presents a rare yet significant clinical challenge.
• Delayed presentation and concealed ingestion history complicate diagnosis and management.
• Ferrous sulfate overdose can lead to severe multi-organ dysfunction.

Purpose of the Study:

• To report a case of severe, late-presenting iron poisoning in an adult.
• To highlight diagnostic challenges associated with denial of ingestion.
• To emphasize the role of supportive and salvage therapies in severe iron toxicity.

Main Methods:

• Case report of a 21-year-old male with delayed presentation of iron overdose.
• Clinical assessment including gastrointestinal symptoms, jaundice, encephalopathy, and coagulopathy.
• Management involved supportive care and advanced extracorporeal therapies.

Main Results:

• Patient presented 4 days after ingesting ferrous sulfate tablets with non-specific symptoms.
• Diagnosis was delayed due to patient denial, passing the window for early decontamination or chelation.
• Supportive care and extracorporeal therapies led to hepatic and renal recovery.

Conclusions:

• High clinical suspicion is crucial for diagnosing late-presenting iron poisoning.
• Thorough history taking is essential, even with patient denial.
• Salvage therapies, including extracorporeal treatments, can be life-saving in severe, late-stage iron toxicity.