Severe iron poisoning treated with prolonged deferoxamine infusion: a case report

Abstract

The incidence of iron poisoning, once the most common cause of fatal pediatric unintentional ingestions, and the use of its antidote deferoxamine have declined. We describe a case of a 17-year-old girl who presented to a hospital following an intentional polysubstance ingestion, which included ferrous sulfate. She developed severe gastrointestinal symptoms including hematemesis, as well as anion gap metabolic acidosis, coagulopathy, and liver toxicity. She was treated with a prolonged course of greater than 24 h with deferoxamine due to a markedly elevated serum iron concentration of 2565 g/dL and worsening clinical status. Clinical features and management of complex iron poisoning are discussed. This case demonstrates the benefit of early poison control center and medial toxicology involvement in instances regarding the off-label usage of deferoxamine in the treatment of severe iron toxicity.