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September 1980

Acute Iron Poisoning: A Review

Author Affiliations

From the Departments of Pediatrics (Drs Robotham and Lietman) and Pharmacology (Dr Lietman), The Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore. Dr Robotham is now with the University of Texas Health Science Center at San Antonio.

Am J Dis Child. 1980;134(9):875-879. doi:10.1001/archpedi.1980.02130210059016

The accidental ingestion of iron-containing preparations is relatively common in childhood, and intentional overdosage with iron is occasionally seen in adults. Though rarely fatal, the consequences of a substantial iron ingestion can result in profound mental retardation or death. The availability of deferoxamine mesylate, a specific and tenacious chelator of iron, and the necessity for its early administration demand that the physician be aware of a rational approach to the therapy for iron poisoning.

Owing to our current understanding of the pathophysiology of iron poisoning, we believe that the simultaneous oral and continuous intravenous (IV) administration of deferoxamine offers the most rational specific therapy for this condition. In this review we shall outline the clinical description, pathophysiology, and therapeutic regimens for acute iron intoxication. We have used this information to derive an approach we believe to be reasonable.

CLINICAL DESCRIPTION  The oral lethal dose (LD) of elemental iron is generally

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