title: [Iron intoxication--poisoning with easily accessible medicines].
abstract: A 20-year-old woman was found semiconscious on the floor in a pool of black diarrhea with an empty 100 jar of ferrous sulphate beside her (100 mg Fe2+/tablet), 160 mg/kg. She was brought to the hospital an estimated 4 hours after ingestion and presented with irritability and a fluctuating CNS depression. Her blood pressure was 190/85 mmHg and pulse 130 bpm. An arterial blood gas analysis showed pH 7.17, pCO2 5.4 kPa, pO2 16.7 kPa and BE –14 mmol/l. Deferoxamine was started immediately with a dose of 15 mg/kg/h intravenously. The patient was intubated in the ICU and whole bowel irrigation was performed. Due to technical problems with the venous blood sampling, a correct measurement of the serum iron concentration (s-Fe2) was not at hand until 15 hours post ingestion and showed 131 µmol/l. At that point her condition deteriorated with circulatory instability, hepatic failure, coagulopathy and renal insufficiency. Despite full treatment including continuous renal replacement therapy she died after 4 Days.
authors.forename: Karolina
authors.initials: K
authors.lastname: Galmén
authors.forename: Jonas
authors.initials: J
authors.lastname: Höjer
mesh_terms: D000328:Adult; D003676:Deferoxamine / Q000008:administration & dosage / Q000627:therapeutic use; D062787:Drug Overdose / Q000150:complications* / Q000188:drug therapy / Q000628:therapy; D017809:Fatal Outcome; D005260:Female; D005296:Ferrous Compounds / Q000506:poisoning*; D006801:Humans; D019190:Iron Overload / Q000150:complications* / Q000188:drug therapy / Q000628:therapy; D017262:Siderophores / Q000008:administration & dosage / Q000627:therapeutic use; D013405:Suicide
chemical_list: D005296:Ferrous Compounds; D017262:Siderophores; D003676:Deferoxamine