To the Editor.—
Usual adverse effects from intramuscular iron dextran injections include skin pigmentation and transient pain localized at the injection site. Muscle necrosis and tissue fibrosis have been demonstrated experimentally with multiple high-dose injections of iron dextran in some animals,1 but muscle necrosis with ulceration of overlying skin has not been reported previously in man.
Report of a Case.—
A 72-year-old man with a ten-year history of rheumatoid arthritis presented in August 1986 for evaluation of hip ulcers bilaterally. The ulcerations occurred where he had previously received iron dextran injections for the treatment of an undefined anemia. He was given approximately 350 injections over five years, alternating between hips. Assuming 2-mL injections of 50 mg/mL (1.2 mg/kg) of Imferon, the cumulative dose was estimated to be 37 000 mg (435 mg/kg). Since his initial visit to the clinic in 1984, he had not received any iron dextran injections.
Fuller JD, Williams HJ, McRorie TI. Necrotic Bilateral Buttocks Ulcerations Occurring After Multiple Intramuscular Iron Dextran Injections. Arch Dermatol. 1988;124(11):1722-1723. doi:10.1001/archderm.1988.01670110078023