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November 22, 1971, Vol 218, No. 8 >
ARTICLE | November 22, 1971

Acute Iron Poisoning in Children: Title and subTitle BreakThe Problem of Appropriate Therapy FREE

David S. Fischer, MD; Robertson Parkman, MD; Stuart C. Finch, MD
[+] Author Affiliations

Reprint requests to 111 Park St, New Haven, Conn 06511 (Dr. Fischer).


JAMA. 1971;218(8):1179-1184. doi:10.1001/jama.1971.03190210033006
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References

A ten-year study of all cases of excessive ingestion of iron compounds seen at two hospitals serving a population of about 400,000 people revealed 27 childhood cases. None of them died, but one experienced moderate morbidity, probably related to therapy with a chelating agent. A rapid method for the detection of iron in excess of the iron-binding capacity was found to be of great value in helping to decide which cases required immediate therapy with a specific chelate and which cases could be managed symptomatically. Therapy was usually begun with lavage of the stomach with a phosphate salt to bind all unabsorbed iron. The chelate deferoxamine mesylate was used only when there was free iron demonstrated in the serum. Most cases recovered with symptomatic therapy.

REFERENCES

1 +
Forbes G:  Poisoning with preparation of iron, copper and manganese . Brit Med J 1:367370, 1947;.
2 +
Aldrich R:  Acute iron toxicity , in Wallerstein RO, Mettier SR (eds): Iron in Clinical Medicine . Berkeley, Calif, University of California Press, 1958;.
3 +
 Annotation of ferrous sulfate poisoning in childhood . Lancet 1:869-870, 1961;.
4 +
Nat Clearinghouse Poison Contr Cent Bull (May) -June 1966;, p 6.
5 +
McEnery JT, Greengard J:  Treatment of acute iron ingestion with deferoxamine in 20 children . J Pediat 68:773-779, 1966.
6 +
Peters T, Giovaniello TJ, Apt L, et al:  A simple improved method for the determination of serum iron . J Lab Clin Med 48:280-288, 1956;.
7 +
Peters T, Giovaneillo TJ, Apt L, et al:  A new method for the determination of serum iron binding capacity . J Lab Clin Med 48:274-279, 1956;.
8 +
Fischer DS, Price DC:  A simple serum iron method using the new sensitive chromogen tripyridyl-s-triazine . Clin Chem 10:21-31, 1964;.
9 +
Fischer DS:  A method for the rapid detection of acute iron toxicity . Clin Chem 13:6-11, 1967;.
10 +
Zettner A:  Application for atomic absorption spectrophotometry in the determination of iron in urine . Amer J Clin Path 44:517-519, 1965;.
11 +
Schwietzer C:  Die Beeinflussung der Eisenresorption durch Polyphosphate . Biochem Z 328:35-38, 1956;.
12 +
Brock FJ, Diamond LK:  Rickets in rats by iron feeding . J Pediat 4:442-453, 1954;.
13 +
Beutler E, Fairbanks VF, Fahey JL: Clinical Disorders of Iron Metabolism . New York, Grune & Stratton, 1963;, p 199.
14 +
Gleason MN, Gosselin RE, Hodge HC: Clinical Toxicology of Commercial Products: Acute Poisoning (Home and Farm) . Baltimore, Williams & Wilkins Co, 1963;, pp 76.
15 +
Moeschlin S, Schnider U:  Treatment of primary and secondary hemochromatosis and acute iron poisoning with a new, potent ironeliminating agent (fesferrioxamine B) New Eng J Med 269:57-66, 1963;.
16 +
Whitten CF, Gibson GW, Good MH, et al:  Studies in acute iron poisoning: I. Desferrioxamine in the treatment of acute iron poisoning: Clinical observations, experimental studies, and theoretical considerations . Pediatrics 36:322335, 1965;.
17 +
Reissman K, Coleman TJ, Budai BS, et al:  Acute intestinal iron intoxication: I. Iron absorption, serum iron, and autopsy findings . Blood 10:35-45, 1955;.
18 +
Westlin WF:  Desferroxamine in the treatment of acute iron poisoning . Clin Pediat 5:531-535, 1955;.
19 +
Jacobziner H, Raybin H:  Accidental chemical poisoning: Iron intoxication . New York J Med 62:85-87, 1962;.
20 +
Shapiro N, Barbezat GO:  A case report of acute iron poisoning treated with desferrioxamine B . S Afr Med J 38:461-463, 1964;.
21 +
Whitten CF, Chen YC, Gibson GW:  Studies in acute iron poisoning: II. Further observations of desferrioxamine in the treatment of acute experimental iron poisoning . Pediatrics 38:102-110, 1966;.

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1 +
Forbes G:  Poisoning with preparation of iron, copper and manganese . Brit Med J 1:367370, 1947;.
2 +
Aldrich R:  Acute iron toxicity , in Wallerstein RO, Mettier SR (eds): Iron in Clinical Medicine . Berkeley, Calif, University of California Press, 1958;.
3 +
 Annotation of ferrous sulfate poisoning in childhood . Lancet 1:869-870, 1961;.
4 +
Nat Clearinghouse Poison Contr Cent Bull (May) -June 1966;, p 6.
5 +
McEnery JT, Greengard J:  Treatment of acute iron ingestion with deferoxamine in 20 children . J Pediat 68:773-779, 1966.
6 +
Peters T, Giovaniello TJ, Apt L, et al:  A simple improved method for the determination of serum iron . J Lab Clin Med 48:280-288, 1956;.
7 +
Peters T, Giovaneillo TJ, Apt L, et al:  A new method for the determination of serum iron binding capacity . J Lab Clin Med 48:274-279, 1956;.
8 +
Fischer DS, Price DC:  A simple serum iron method using the new sensitive chromogen tripyridyl-s-triazine . Clin Chem 10:21-31, 1964;.
9 +
Fischer DS:  A method for the rapid detection of acute iron toxicity . Clin Chem 13:6-11, 1967;.
10 +
Zettner A:  Application for atomic absorption spectrophotometry in the determination of iron in urine . Amer J Clin Path 44:517-519, 1965;.
11 +
Schwietzer C:  Die Beeinflussung der Eisenresorption durch Polyphosphate . Biochem Z 328:35-38, 1956;.
12 +
Brock FJ, Diamond LK:  Rickets in rats by iron feeding . J Pediat 4:442-453, 1954;.
13 +
Beutler E, Fairbanks VF, Fahey JL: Clinical Disorders of Iron Metabolism . New York, Grune & Stratton, 1963;, p 199.
14 +
Gleason MN, Gosselin RE, Hodge HC: Clinical Toxicology of Commercial Products: Acute Poisoning (Home and Farm) . Baltimore, Williams & Wilkins Co, 1963;, pp 76.
15 +
Moeschlin S, Schnider U:  Treatment of primary and secondary hemochromatosis and acute iron poisoning with a new, potent ironeliminating agent (fesferrioxamine B) New Eng J Med 269:57-66, 1963;.
16 +
Whitten CF, Gibson GW, Good MH, et al:  Studies in acute iron poisoning: I. Desferrioxamine in the treatment of acute iron poisoning: Clinical observations, experimental studies, and theoretical considerations . Pediatrics 36:322335, 1965;.
17 +
Reissman K, Coleman TJ, Budai BS, et al:  Acute intestinal iron intoxication: I. Iron absorption, serum iron, and autopsy findings . Blood 10:35-45, 1955;.
18 +
Westlin WF:  Desferroxamine in the treatment of acute iron poisoning . Clin Pediat 5:531-535, 1955;.
19 +
Jacobziner H, Raybin H:  Accidental chemical poisoning: Iron intoxication . New York J Med 62:85-87, 1962;.
20 +
Shapiro N, Barbezat GO:  A case report of acute iron poisoning treated with desferrioxamine B . S Afr Med J 38:461-463, 1964;.
21 +
Whitten CF, Chen YC, Gibson GW:  Studies in acute iron poisoning: II. Further observations of desferrioxamine in the treatment of acute experimental iron poisoning . Pediatrics 38:102-110, 1966;.

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