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Severe iron intoxication treated with exchange transfusion.

Carlsson M, Cortes D, Jepsen S, Kanstrup T

Pediatric Intensive Care Unit, Afdeling V, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C., Denmark. marcelacarlsson@yahoo.dk

An 18-month-old previous healthy girl who had ingested 442 mg elemental iron/kg was admitted to a paediatric intensive care unit. The child was treated with gastric lavage, whole bowel irrigation and intravenous deferoxamine. After 2 h of standard therapy serum iron had risen threefold to 1362 microg/dl (244 micromol/l). The child was treated with exchange transfusion (ET; 52 ml/kg) and serum iron fell to 134 microg/dl (24 micromol/l). The patient made an uncomplicated recovery. ET should be considered in severe iron poisoning when standard therapy is inadequate.

Published 21 March 2008 in Arch Dis Child, 93(4): 321-2.
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