| Title | Acute liver failure due to iron overdose in an adult. | | Author(s) | Daram SR, Hayashi PH | | Institution | Division of Gastroenterology and Hepatology, Department of Internal Medicine, Saint Louis University School of Medicine, St Louis, MO 63110, USA. | | Source | South Med J 2005 Feb; 98(2):241-4. | | MeSH | Adolescent
Alanine Transaminase
Deferoxamine
Female
Humans
Iron
Iron Chelating Agents
Liver Failure, Acute
Overdose
Suicide, Attempted
Treatment Outcome
| | Abstract | The vast majority of acute iron toxicity cases occur in children less than 5 years of age. Moreover, clinical hepatic injury is uncommon with most symptoms stemming from the intestinal tract (eg, nausea, vomiting, diarrhea). Therefore, physicians, particularly those who do not routinely treat pediatric patients, are often unfamiliar with hepatotoxicity related to iron overdose. Nevertheless, hepatotoxicity caused by acute iron poisoning is associated with a high mortality rate. We report a case of severe hepatic injury in an adult who overdosed on iron tablets with suicidal intent. Tests for other hepatotoxins (eg, acetaminophen), hepatatrophic viruses, and other causes of acute liver injury were negative. Although peak serum iron level (340 microg/dL) was significantly lower than that reported to cause hepatotoxicity (>1,700 microg/dL), rapid and significant elevations in aminotransferases (>4,000 U/L), total bilirubin (5 mg/dL), and prothrombin time (50 seconds) occurred within 48 hours. Treatment with deferoxamine was prompt and followed by empiric N-acetylcysteine once liver injury was apparent. The patient was minimally symptomatic and she eventually had a full recovery. | | Language | eng | | Pub Type(s) | Case Reports
Journal Article
| | PubMed ID | 15759960 |
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