May 1980

Phosphate Poisoning Complicating Treatment for Iron Ingestion

Author Affiliations

From the Department of Pediatrics, (Dr Geffner), and the Division of Pediatric Nephrology (Dr Opas), Los Angeles County-University of Southern California Medical Center, Los Angeles.

Am J Dis Child. 1980;134(5):509-510. doi:10.1001/archpedi.1980.02130170059020

• A 15-month-old child was treated for iron intoxication with a hypertonic sodium phosphate mixture. Clinical deterioration manifested by fever, obtundation, abdominal distention, dehydration, and hypotension followed soon after the administration of this mixture. Such symptoms may occur with either iron overdosage or with phosphate poisoning. At this time, the patient's serum chemistry values included: iron, 49 μg/dL; phosphorus, 24.6 mg/dL; and calcium, 4.5 mg/dL. The hypocalcemia, hyperphosphatemia, and dehydration were treated with parenteral gluconate calcium, intravenous fluids, and general supportive measures. Although the child had an uneventful recovery despite severe phosphate poisoning, therapeutic alternatives, such as sodium bicarbonate, should be used as adjuncts in the treatment of acute iron ingestion.

(Am J Dis Child 134:509-510, 1980)