Iron poisoning

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Pathophysiology

In excessive quantities, iron is severely corrosive to the gastrointestinal tract. There is often nausea, vomiting and haematemesis.
Mucosal necrosis, ulceration, and ischaemia can be seen. Perforation of the GI tract may develop, rapidly resulting in hypovolaemic shock.

As iron is absorbed into the body it can cause:

• Metabolic acidosis. 
• Distributive shock through vasodilation. This is somewhat similar to the mechanism of shock during anaphylaxis. 
• Acute kidney injury.
• Fulminant liver failure.
• Disseminated intravascular coagulation.

All of these are life-threatening sequelae.

 

Management

• Immediate management of the acute situation on presentation.
• Chelation therapy with deferoxamine. 
• Dialysis.