Infantile iron poisoning: Challenges in diagnosis and management

Abstract

To describe the clinical course and treatment of an infant with iron poisoning. Case report. Pediatric intensive care unit in a tertiary care children's hospital. A 7-week-old, ex-28-week premature infant, was accidentally poisoned with ferrous sulfate. She recovered completely from metabolic acidosis and shock after treatment with inotropes and chelation with deferoxamine, but her management was complicated by challenges of physiologic immaturity of developing organs. This is the youngest infant reported, to date, with iron poisoning resulting in metabolic acidosis and shock. This case illustrates the importance of including toxic exposure in the differential diagnosis of neonatal shock of unknown etiology. Because of physiologic immaturity, iron poisoning in young infants poses special diagnostic and therapeutic challenges.