Hard as Iron: A Case of Delayed Presentation of Severe Iron Toxicity with Diagnostic and Treatment Dilemmas

Shannon S Rickner-Schmidt, Sing Yi Feng

Research output: Contribution to journalArticlepeer-review

Abstract

Cases of severe iron toxicity have become increasingly rare; most cases are intentional ingestions by late adolescents and adults who present within 12 hours of ingestion. We present a case of an adolescent girl with metabolic acidosis, hypoglycemia, obtundation, and liver and renal failure of undifferentiated etiology who was eventually discovered to have overdosed on ferrous sulfate tablets 4 days before arrival. The diagnosis was made because the patient had an elevated transferrin concentration in the setting of a minimally elevated serum iron concentration and faint radio-opacities on abdominal plain film imaging. This case presents many diagnostic challenges and treatment dilemmas and is a rare report of survival in delayed presentation of severe toxicity.

Original languageEnglish (US)
Pages (from-to)E269-E271
JournalPediatric emergency care
Volume37
Issue number5
DOIs
StatePublished - 2021

Keywords

  • adolescent
  • chelation
  • hemodialysis
  • iron poisoning
  • overdose
  • plasma exchange
  • suicide attempt
  • transplant

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Emergency Medicine

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