title: Leukocytosis, hyperglycemia, vomiting, and positive X-rays are not indicators of severity of iron overdose in adults.
abstract: To determine whether leukocytosis, hyperglycemia, vomiting, and opacities in abdominal radiographs are indicators of a serum iron concentration of > 300 micrograms/dL in adult iron overdose patients, a retrospective medical record review was undertaken at a university medical center of all patients older than 12 years of age for whom clinical data were collected before deferoxamine therapy and within 6 hours of iron ingestion. Forty-three patients met the inclusion criteria; 37 were female. The mean and range serum iron concentrations were 382 micrograms/dL and 58 to 710 micrograms/dL, with 34 patients having values of > 300 micrograms/dL. There were no statistically significant relationships between iron concentration of > 300 microgram/dL and leukocytosis, hyperglycemia, vomiting, and opacities in abdominal radiographs (P > .05). Sensitivities, specificities, and positive and negative predictive values indicate poor performance of these parameters as clinical predictors of serum iron concentration of > 300 micrograms/dL. Leukocytosis, hyperglycemia, vomiting, or the presence of opacities in abdominal X-rays are not indicators of a serum iron concentration of > 300 micrograms/dL in adults. These parameters should not be used to assess the severity of iron overdose or to guide its management.
authors.affiliation: Department of Emergency Medicine, University of Manitoba, Winnipeg, Canada.
authors.forename: W
authors.initials: W
authors.lastname: Palatnick
authors.forename: M
authors.initials: M
authors.lastname: Tenenbein
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D003676:Deferoxamine / Q000627:therapeutic use; D062787:Drug Overdose / Q000097:blood; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced*; D007501:Iron / Q000506:poisoning*; D007958:Leukocyte Count; D007964:Leukocytosis / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D011041:Poisoning / Q000097:blood / Q000188:drug therapy; D011860:Radiography, Abdominal; D012189:Retrospective Studies; D014839:Vomiting / Q000139:chemically induced
chemical_list: D001786:Blood Glucose; D007501:Iron; D003676:Deferoxamine