injuries poisoning
Iron Poisoning
Key Points
Iron toxicity, like some other hepatotoxins, can cause gastroenteritis followed by a quiescent phase, then shock and liver failure. Suspect iron poisoning in mixed ingestions (because iron is ubiquitous) and in small children with access to iron and unexplained metabolic acidosis or severe or hemorrhagic gastroenteritis. Suspect that toxicity is severe with increasing iron levels, metabolic acidosis, worsening symptoms, or a combination. Do whole-bowel irrigation until an abdominal x-ray shows absence of radiopaque iron products. Give IVdeferoxamineto treat severe poisoning (eg, metabolic acidosis, shock, severe gastroenteritis, serum iron level>500 mcg/dL [89.5 micromol/L]). 