Iron poisoning

[Kai]

Symptoms develop in stages and begin with vomiting, diarrhea, and abdominal pain.
Liver failure can develop days later.
The diagnosis is based on the person’s history, symptoms, and the amount of iron in the blood.
People with iron poisoning need to be hospitalized.

(See also Overview of Poisoning.)
Pills containing iron are commonly used to treat certain kinds of anemia. Iron also is included in many multiple vitamin supplements. People—especially toddlers—who overdose on these pills may develop iron poisoning. Because many households contain adult multiple vitamin supplements that contain iron, iron overdose is common. However, children’s chewable iron-containing vitamins do not contain very much iron, so even a whole bottle does not provide enough iron to cause serious poisoning. Overdose of pure iron supplements, however, may cause serious iron poisoning. Prenatal vitamins contain a lot of iron and may poison a small child.
Iron poisoning is a potential cause of fatal poisoning in children younger than age 5. It first irritates the stomach and digestive tract, sometimes causing bleeding. Within hours, iron poisons the cells, interfering with their internal chemical reactions. Within days, the liver can be damaged. Weeks after recovery, the stomach, digestive tract, and liver can develop scars due to the previous irritation.

[Zipporah Schumaker]

Iron poisoning is a leading cause of poisoning deaths in children. Symptoms begin with acute gastroenteritis, followed by a quiescent period, then shock and liver failure. Diagnosis is by measuring serum iron, detecting radiopaque iron tablets in the gastrointestinal tract, or detecting unexplained metabolic acidosis in patients with other findings suggesting iron poisoning. Treatment of a substantial ingestion is usually whole-bowel irrigation and chelation therapy with IV deferoxamine .
(See also General Principles of Poisoning.)
Many commonly used over-the-counter (OTC) preparations contain iron. Of the many iron compounds used in OTC and prescription preparations, the most common are

Ferrous sulfate (20% elemental iron)
Ferrous gluconate (12% elemental iron)
Ferrous fumarate (33% elemental iron)

To children, iron tablets may look like candy. Prenatal multivitamins are the source of iron in most lethal ingestions among children. Children’s chewable multivitamins with iron usually have such small amounts that toxicity rarely occurs.