Case report
Severe iron intoxication treated with exchange transfusion
1 Pediatric Intensive Care Unit, Odense University Hospital, Odense, Denmark
2 Department of Pediatrics, Odense University Hospital, Odense, Denmark
3 Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
Correspondence to:
Dr Marcela Carlsson, Pediatric Intensive Care Unit, Afdeling V, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C., Denmark; marcelacarlsson{at}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 µg/dl (244 µmol/l). The child was treated with exchange transfusion (ET; 52 ml/kg) and serum iron fell to 134 µg/dl (24 µmol/l). The patient made an uncomplicated recovery. ET should be considered in severe iron poisoning when standard therapy is inadequate.
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