Iron tablets
Summary
Iron supplements (ferrous sulfate) treat iron-deficiency anemia but are a common cause of pediatric poisoning. Acute overdose causes GI hemorrhage, metabolic acidosis, and hepatic necrosis.
Detail
Iron tablets (ferrous sulfate, fumarate, gluconate) replete iron stores in iron-deficiency anemia; absorption is enhanced by vitamin C and impaired by PPIs and calcium. Acute toxicity (often pediatric ingestion of prenatal vitamins) progresses in 5 stages: (1) 0-6h GI distress with hemorrhagic gastroenteritis, (2) 6-24h latent period, (3) shock and high-anion-gap metabolic acidosis (free radical injury), (4) hepatotoxicity at 48-96h, (5) gastric outlet obstruction from scarring weeks later. Radiopaque pills visible on abdominal X-ray. Treatment: whole-bowel irrigation, IV deferoxamine chelation (urine turns vin rosé). Boards: leading cause of pediatric poisoning death historically.
Sources
- First Aid for USMLE Step 1 2024
- Goljan Rapid Review Pathology
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