Iron poisoning: signs, symptoms, treatment
In medicine preparations based on iron used here is not the first century. However, the first iron poisoning (at least, documented) occurred only in the middle of the last century. Over time the situation deteriorated, and by the 1990s iron became one of the main causes of poisoning in children under 6 years.
Since 1997, each tool consisting of iron salts, in the package put a warning about the possible poisoning of the metal. In addition, have been taken and other measures, including limiting the number of the drug issued to the patient, allowing the result to reduce the percentage of iron poisoning.
The causes of poisoning and the dose
Poisoning with iron preparations today people get intentionally or accidentally. To purchase most drugs with this trace element is possible even without prescription from a doctor, it is a component of many vitamin complexes and supplements. The dose of 30 mg/kg of body weight is considered toxic to the body, a dose of 20-60 mg/kg entails the symptoms of moderate severity. However, the lethal dose is much higher it is 250 mg. In the case of younger children the amount of overdose is much lower because it is especially dangerous such poisoning for children.
Overdose of iron is divided into acute and chronic. In the first case, the defeat of the organism develops in less than a day. Chronic damage most often occurs due to medical mistakes or missteps of the patient. The condition occurs due to an incorrectly administered dose of the drug or its excess. Most often poisoning is manifested as ischemia, inflammation of the kidneys, and sometimes it becomes a cause of cancer. Mild cases are characterized by problems with gastrointestinal tract and heartburn.
When exceeding the normal for the human body iron content first strike get the bodies Central nervous system, heart and digestive tract. Also serious damage attributable to oxidation processes in the body.
The body uses the trace mineral in the processes of work. Especially popular iron in some metabolic processes related to myoglobin. Iron is distributed throughout the body, but the overwhelming amount of hemoglobin, about 20% - ferritin plays a small percentage already mentioned myoglobin. Absorbed iron from medical drugs through the mucosa of the stomach and intestines, and the bloodstream in the form of 3-valent iron. The resulting trace element the body or sends to the reserve, or directly in the bone marrow. Every day, the body naturally secretes about 1 mg of iron.
Harm in overdose produces free iron, which certainly occurs when taking too large doses of drugs. Due to peroxidation of damaged cells, and mitochondrial damage. Overdose may be fatal, which is caused by a variety of pathological changes the most characteristic of which is damage to the cardiac muscle cells and hepatocytes, and necrosis of the gastrointestinal tract. Iron deposits accumulate in the liver, spleen and intestines.
Symptoms of acute poisoning are rapidly developing for several hours. In some cases, the symptoms of the disease confined to diarrhea and nausea – this suggests that the body was able to neutralize the bulk of the excess dose of the trace mineral. If the body itself can not cope with poisoning of iron, the disease occurs in a different scenario, which includes 4 main stages with different symptoms.
The first stage
The first stage lasts about 6 hours. Most of the symptoms associated with lesions of the gastrointestinal tract. The most striking indications: disruption of the gastro-intestinal tract and cramps. A particular danger of hemorrhagic gastritis. Due to its rapid development possible bleeding from the stomach.
While considerable damage was accounted for by the CNS. During the first stage of poisoning is recorded irritability and sleepiness, the number of heartbeats gradually decreases, decreases blood pressure. As a result the person loses consciousness, and this is one of the most adverse clinical signs in this disease.
The second stage
The second stage is much longer – it stretches approximately 12 hours. The patient is feeling well, his health is markedly improved. The symptoms subside or disappear altogether. Unfortunately, in most cases, the improvement is about: overdose of iron continues to have negative effects on the body.
The third stage
The third stage may last up to 48 hours. While it begins to go into shock, BP drops, blood flow is reduced. If during this period to get tested, they can show normal levels of trace elements, while the sugar will be lowered. Can also be detected and signs of liver damage. In some cases, fever, mucous membranes and some internal organs begin to bleed. Among other signs – jaundice, disorientation, anxiety, and convulsions. The main impact at this stage is on the kidneys, lungs and liver, damage the heart.
The longest – up to several months. During this stage is scarring of the pylorus or small intestine, but this pathology develops due to healing ulcers that have formed under the action of the corrosive properties of iron on the mucosa.
Medicine associates the deterioration of human poisoning with iron only after carefully conducted blood tests or according to the victim, if he can clarify what he was taking before degradation. Of particular difficulty is the definition of a drug that caused the poisoning in children.
Iron itself for x-ray impervious, so as to identify it only on review radiographs of the stomach. A similar method is used for the confirmation of the effectiveness of selected treatment methods.
In some cases, the provocative test is performed with the participation of deferoxamine. This technique allows to detect the moment when the amount of iron in the body exceeds the capacity of a body to process it.
The most accurate way of determining overdose, is a test of the content of iron in the blood.
First aid and treatment
If a person manifests symptoms of iron poisoning, the first thing to do is to immediately call an ambulance. Until the doctors get there, you must provide a victim with emergency assistance.
In cases of poisoning with iron should be thoroughly washed stomach of the patient plenty of fluids. For this you need to give him a few liters of warm water, and then induce vomiting. This is done by clicking on the tongue. If the person is unconscious, it is best to bring it to fresh air, if necessary, to unbutton clothes and loosen the tie.
All other manipulations will be to produce doctors at the hospital. Remember that to make a decision about the need for hospitalization can only be a specialist. It will determine whether the victim in the home to be treated to a normal state or he will need more care.
The first thing after getting to the hospital the victim will do x-rays of the abdomen, which allows to detect iron-containing pills. To verify treatment success photos will be doing continuously with some frequency.
As the primary means of combating the overdose of iron used deferoxamine. The drug is injected intravenously. Doctors use it in cases of overdose characterized by the phenomenon of shock, frequent vomiting, acidosis and symptoms of intoxication. When such poisoning serum iron in the blood exceeds 500 mg. One of the side effects of this drug is to lower blood pressure. A similar effect occurs in cases of poisoning with iron, so the cure and the disease will in fact reinforce each other's action. Therefore, deferoxamine is used only in exceptional cases and once the metabolic acidosis is corrected, then overturned it.
General treatment of iron poisoning are selected on the basis of the patient's General condition and symptoms. In the case of reducing blood pressure, for example, the victim is assigned colloidal solutions, and acidosis metabolism corrected with sodium bicarbonate, which is administered intravenously. Problems with blood clotting often arise due to massive liver damage, in this case, the course is fresh-frozen plasma and vitamin K.
The effectiveness of the treatment the doctors. In the first turn, tracked the concentration of iron in the blood. Also you can focus on the approach and shade of the urine to normal color.
Exchange transfusion and hemodialysis in cases of poisoning by preparations based on iron show little result. One should not hope for a popularly known remedy is charcoal. Since the drug does not bind iron components, and the effect of it is missing. As a result of the treatment of bleeding in some cases may develop anemia.
Prognosis in case of timely treatment is often favourable, the mortality is about 1%. However, in cases when the patient arrives in an unconscious state or a state of shock, this figure increases to 10%.
It should be noted that the poisoning with iron today is quite rare. However, families with children, where someone takes iron supplements should ensure inaccessibility. The same applies to relatives with mental illness. Often, chronic poisoning is associated with long-term administration of drugs. That is why it is important in case of health problems to contact a qualified technician instead to self-medicate. Prescribed drugs should drink it in those doses which appointed the attending physician.