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[Acute poisoning by I.M. iron. Report of a fatal case (author's transl)]
Insights
A five-month-old infant experienced severe metabolic acidosis, organ failure, and seizures after an iron-sorbitol overdose. Standard treatments, including desferrioxamine, were ineffective in managing the iron toxicity.
Area of Science:
- Pediatric toxicology
- Pharmacology
- Emergency medicine
Background:
- Iron-sorbitol is an intramuscular iron preparation used to treat iron deficiency anemia.
- Accidental overdose of iron preparations can lead to severe toxicity.
Observation:
- A 5-month-old infant mistakenly received an intramuscular dose of 44 mg/Kg of iron-sorbitol, approximately ten times the standard dosage.
- The infant initially presented with vague symptoms and transient improvement, followed by rapid deterioration.
Findings:
- The patient developed severe metabolic acidosis, acute renal failure, hepatic failure, and generalized seizures.
- Standard supportive care, desferrioxamine administration, and exanguino-transfusion failed to control the iron toxicity.
Implications:
- This case highlights the potential for severe toxicity from iron-sorbitol overdose in infants.
- It underscores the need for careful dosage calculation and administration of iron preparations.
- The limited efficacy of standard treatments emphasizes the critical nature of iron poisoning and the potential need for novel therapeutic strategies.
Abstract:
The case of a five months-old child who received 44 mg/Kg of Fe-sorbitol I.M. by mistake is reported. That dose is about ten times the usual standard dosage. After an initial vague symptomatology, followed by transitory improvement, she developed a serious metabolic acidosis, renal and hepatic failure and generalized convulsions. The clinical picture could not be controlled by general supportive treatment, desferroxamine administration and exanguino-transfusion.