Abstract
Iron toxicity is less likely to occur with intravenous form; however it is commonly caused by excessive intake of oral form. Oral iron overdose usually takes place in the background of suicidal attempts or in children. Meanwhile, intravenous iron toxicity was seldom reported in literature. Intravenous iron toxicity may present with abdominal pain, diarrhea, hypotension, altered level of consciousness, muscular pain, and anaphylaxis. Moreover, serious complications may develop including multi-organ failure and possible fatality. The toxicity of iron starts at cellular level as it impairs mitochondrial function and oxidative phosphorylation. Once iron toxicity is suspected, serum iron levels should be measured within 2-6 hours from the time of administration. Initial management should be started by stabilizing the patient and iron chelating agents.
In this report, we present a rare case of iatrogenic IV iron sucrose toxicity in a 41-year-old female status post sleeve gastrectomy surgery known to have iron deficiency anemia presented with altered level of consciousness shortness of breath, and generalized body swelling. Her initial presentation was followed by hypotension and bradycardia hence she was managed provisionally as a case of anaphylaxis. Her serum iron level was 527 mcg/dL measured after five hours from IV iron sucrose administration. In present case, patient received a combination of IV Deferoxamine and oral Deferasirox. A day after admission, patient was discharged home on Deferasirox in a good condition.