Serum Iron Concentrations and Symptoms of Acute Iron Poisoning in Children

Abstract

Study Objective. To determine whether serum iron concentrations correlate with the development of symptoms of iron poisoning in children.Design. A retrospective study of medical records from January 1976 through June 1992.Setting. A tertiary care children's medical center.Patients. Criteria for patient selection included an acute ingestion of iron‐containing drugs, measurement of serum iron prior to deferoxamine administration, and a serum iron concentration (obtained within 2–9 hours of exposure) that was greater than 150 μg/dl (27 μmol/L). Of the 128 children who were hospitalized for acute iron poisoning, 92 patients (mean age 2.3 ± 2.2 years) met the selection criteria.Interventions. None.Measurements and Main Results. The mean (± SD) serum iron concentrations (μg/dl) of patients who exhibited cardiovascular instability (725 ± 555, n = 6; p < 0.001) differed from those categorized with central nervous system changes (373 ± 77, n = 30), gastrointestinal symptoms (334 ± 83, n = 44), and no symptoms (368 ± 102, n = 12). Serum iron concentrations in patients with cardiovascular instability ranged from 205–500 μg/dl (37–269 μmol/L), whereas those with no symptoms ranged from 170–513 μg/dl (30 to 92 μmol/L) demonstrating considerable overlap of ranges.Conclusions. Serum iron concentrations do not necessarily relate to acute toxicity, and further study is needed to demonstrate the value of serum iron concentrations and to identify alternative strategies in the emergency assessment of the acutely poisoned child.