Iron poisoning

Iron poisoning typically occurs from ingestion of excess iron that results in acute toxicity. Mild symptoms which occur within hours include vomiting, diarrhea, abdominal pain, and drowsiness.^[1] In more severe cases, symptoms can include tachypnea, low blood pressure, seizures, or coma.^[2] If left untreated, iron poisoning can lead to multi-organ failure resulting in permanent organ damage or death.^[1]

Iron is available over the counter as a single entity supplement in an iron salt form or in combination with vitamin supplements and is commonly used in the treatment of anemias.^[1][2] Overdoses on iron can be categorized as unintentional ingestion which is predominantly associated with children or intentional ingestion involving suicide attempts in adults.^[3] Unintentional ingestion of iron containing drug products are a major cause of mortality in children under the age of 6 years old in the United States.^[3] As a response, in 1997 the US Food and Drug Administration (FDA) implemented a regulation requiring warning labels and unit dose packaging for products containing more than 30 mg of elemental iron per dose.^[4]

The diagnosis of iron poisoning is based on clinical presentation including laboratory tests for serum iron concentrations and metabolic acidosis along with physical examination. Treatment for iron poisoning involves providing fluid replacement, gastrointestinal decontamination, administering deferoxamine intravenously, liver transplants, and monitoring the patient's condition.^[4] The degree of intervention required depends on whether the patient is at risk for serious toxicity.