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Published 8 May 2009
Cite this as: BMJ Case Reports 2009 [doi:10.1136/bcr.01.2009.1445]
Copyright © 2009 by the BMJ Publishing Group Ltd.

Novel treatment (new drug/intervention; established drug/procedure in new situation)

Severe iron intoxication treated with exchange transfusion

M Carlsson1, D Cortes3, S Jepsen2, T Kanstrup1

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:
Marcela Carlsson, marcelacarlsson{at}yahoo.dk

SUMMARY

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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