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

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

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 undif...

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Bibliographic Details
Published in:Pediatric emergency care Vol. 37; no. 5; pp. e269 - e271
Main Authors: Rickner, Shannon S., Feng, Sing-Yi
Format: Journal Article
Language:English
Published: United States Lippincott Williams & Wilkins 01-05-2021
Subjects:
Acidosis
Adolescent
Drug Overdose
Female
Humans
Iron - poisoning
Liver
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Summary: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.
ISSN:0749-5161
1535-1815
DOI:10.1097/PEC.0000000000002430