Citation

Baranwal AK, Singhi SC. Indian Pediatr. 2003; 40(6): 534-540.

Affiliation

Department of Pediatrics, B.P. Koirala Institute of Health Sciences, Dharan, Nepal.

Copyright

(Copyright © 2003, Indian Pediatrics)

DOI

unavailable

PMID

12824662

Abstract

Serum iron level may not be available and fully reliable in management decision and prognostication in our setting. An estimated ingestion of >60 mg/kg elemental iron, onset of symptoms, blood sugar >150 mg/dL, total leukocyte count >15,000 cumm and presence of iron tablets on abdominal radiograph indicates severe toxicity and need for chelation therapy. Appearance of "vin-rose" color urine following a dose of desferrioxamine may be helpful, but is not seen consistently after chelation therapy. Early decontamination of gut (gastric lavage/whole gut irrigation), desferrioxamine infusion (15 mg/kg/hour in saline), and aggressive management of shock, and organ failure preferably in a PICU are mainstay of management, and has improved the outcome. Shock, coagulopathy (prothrombin index <50%), severe acidosis and acute liver failure are poor prognostic indicators. Guardians should be counseled about safe storage of iron tablets made for adults, and general poisoning prevention measures.

Language: en