Severe iron poisoning treated with enteral and intravenous deferoxamine

An 18-month-old boy ingested approximately 18 g FeSO4, equivalent to 336 mg/kg elemental Fe. He rapidly developed severe gastroenteric symptoms, obtundation, and transient hypotension. The serum iron level two hours after ingestion was 6,798 micrograms/dL. He was treated with deferoxamine intravenously, enterally, and as a lavage solution. His hospital course was notable for lack of severe neurologic, hepatic, metabolic, or cardiovascular complications acutely with apparent complete recovery, although he returned six weeks after ingestion with intestinal obstruction due to a jejunal stricture.