Hard as Iron: A Case of Delayed Presentation of Severe Iron Toxicity With Diagnostic and Treatment Dilemmas. Issue 5 (May 2021)

• Record Type: Journal Article
• Authors: Rickner, Shannon S.; Feng, Sing-Yi
• Is Part Of: Pediatric emergency care. Volume 37:Issue 5(2021)
• Publication Date: 2021-05
• Subjects: iron poisoning -- overdose -- adolescent -- suicide attempt -- chelation -- hemodialysis -- plasma exchange -- transplant; Pediatric emergencies -- Periodicals; 618.92002505
• DOI: 10.1097/PEC.0000000000002430
• Languages: English
• ISSNs: 0749-5161

Abstract

Abstract : 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.