Iron poisoning

Abstract

Iron, represented by Fe on the periodic table, is the fourth most common element found on Earth. Although it has important tasks in the human body such as oxygen transfer, DNA synthesis, and electron exchange, it may also become toxic and harmful in excess. The toxicity of iron poisoning starts to appear with an intake of 20 mg/kg of elementary iron ions, along with GIS symptoms. In iron poisoning, patients usually present with various clinical findings and symptoms such as nausea, vomiting, palpitation, metabolic acidosis, deteriorated respiration, or mental disorders varying up to coma. Intervention in all patients begins with ABC evaluation, obtaining vascular access, monitoring, and (if necessary) providing oxygen support. Endotracheal intubation can be considered to ensure airway security and avoid aspiration, especially for lethargic patients. After abdominal and intestinal lavage, IV support treatment can begin, considering the liquid-electrolyte deficiency of these patients. In patients with a poor general condition and toxic appearance, hemogram, serum iron levels, kidney function tests, liver function tests, serum electrolytes, coagulation panel, arterial or venous blood gas, lactate, and in women of childbearing age, β-Hcg tests should be obtained. Abdominal radiography can be planned in the early stage. In patients thought to have serious iron poisoning, chelation treatment with deferoxamine is administered without delay.

Keywords

• Iron,Poisoning,Toxic

Demir zehirlenmesi

Öz

Demir, Dünya'da en yaygın bulunan dördüncü elementtir. Periyodik tablodaki sembolü Fe'dir. Demirin insan vücudunda oksijen transferi, DNA sentezi ve elektron değişimi gibi önemli görevleri olmasına rağmen, aşırı toksik ve zararlı etkileri vardır. Demir zehirlenmesinin toksisitesi 20 mg/kg elementer demir iyonu alımı ile ortaya çıkmaya başlar. Demir zehirlenmesinde hastalar, bulantı, kusma, çarpıntı, metabolik asidoz, bozulmuş solunum veya komaya kadar değişen bilinç bozuklukları gibi çeşitli klinik bulgular ve semptomlarla karşı karşıya kalabilirler. Tüm hastalarda müdahale, ABC değerlendirmesiyle başlar. Hastanın damaryolu açılır, monitörize edilir ve (gerekirse) oksijen desteği sağlanır. Endotrakeal entübasyon, özellikle bilinç bozukluğu olan hastalar için, hava yolu güvenliğini sağlamak ve aspirasyondan korumak için düşünülebilir. Barsak lavajı nedeniyle oluşabilecek sıvı-elektrolit eksikliği göz önünde bulundurularak IV destek tedavisi başlanabilir. Genel durumu kötü ve toksik görünümü olan hastalardan hemogram, serum demir seviyeleri, böbrek fonksiyon testleri, karaciğer fonksiyon testleri, serum elektrolitleri, pıhtılaşma panelleri, arteriyel veya venöz kan gazı, laktat ve çocuk doğurma çağındaki kadınlar için BetaHcg testi istenebilir. Ayakta direk batın grafisinde erken aşamada planlanabilir. Ciddi demir zehirlenmesi olduğu düşünülen hastalarda demir seviyesi nedeniyle deferoksamin ile şelasyon tedavisi gecikmeden geçilmelidir.

Anahtar Kelimeler

• Demir,Zehirlenme,Toksik

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