Acute iron intoxication is one of the commonest L lethal childhood poisonings in the United States. Iron poisoning almost invariably occurs in the pediatric age group, and the poison is usually in the form of ferrous sulfate tablets prescribed for a pregnant woman in the household of the poisoned child. Ingestion of as few as 10 to 15 five-grain tablets has been lethal. Typically, in the child who has ingested ferrous sulfate, symptoms develop within 30 to 90 minutes, with signs of shock, coma, acidosis, vomiting, diarrhea, and melena. The child may subsequently appear to improve somewhat, but within 10 to 14 hours further acidosis and coma, bleeding, and irreversible shock develop, and the child dies. Autopsy reveals no anatomic cause of death. The pathophysiology remains obscure.
The iron chelater, deferoxamine, promises to reduce substantially the mortality of acute iron intoxication. The agent has not, however, proved to be the