UMEM Educational Pearls

Title: Iron Toxicity Treatment: In vs. Out (so yesterday)

Keywords: Iron; Poisoning; Deferoxamine (PubMed Search)

Posted: 9/3/2009 by Ellen Lemkin, MD, PharmD
Click here to contact Ellen Lemkin, MD, PharmD

Iron Toxicity Treatment
Out	In
Checking TIBC to determine if treatment is necessary	Checking iron levels...If peak is > 500 mcg/dl, or the patient shows signs of systemic toxicity, treat with deferoxamine
Deferoxamine challenge... no longer recommended!	Using WBI for ingestion of 20 mg/kg iron, if visible iron pills on x-ray, or symptoms of mild toxicity (for treatment of severe toxicity see above)
Platform shoes	Strappy sandals

WBI: whole bowel irrigation

Reminder from Poisondex:

OVERDOSE: SEVERE: Stupor, shock, acidosis, GI bleed, coagulopathy, hepatotoxicity, and coma. MILD/MODERATE: Nausea, vomiting, diarrhea, lethargy, leukocytosis, and hyperglycemia. Clinical phases: (1) 0-2 hours: Nausea, vomiting, diarrhea, and abdominal pain. Lethargy, shock, GI bleeding, and acidosis if severe; (2) Apparent recovery; (3) 2-12 hours: Acidosis, hypotension; (4) 2-4 days: Hepatotoxicity; (5) days-weeks: GI strictures.

References

Balmadrid C, Bono M. Recognizing and Managing Iron Toxicity. Emergency Medicine May 2009;14-21.