ACUTE IRON POISONING IN CHILDREN - ROLE OF CHELATING AGENTS

Sixteen cases of accidental iron ingestion treated with di-ethyienetriamine penta-acetic acid (D.T.P.A.) or desferriox-amine are described in detail. One fatality was associated with delay in the onset of specific chelation therapy. In three severe cases recovery was associated with large excretions of iron. Chelation data in apparently mild poisoning showed that two out of 12 cases excreted large amounts of iron, suggesting that potentially more severe intoxication had been averted. No toxic effects attributable to D.T.P.A. or desferrioxamine occurred. At follow-up one severe case had possible neurological sequelae. There were no instances of gastrointestinal stenosis. From these results and a review of the literature it can be concluded that these drugs are biochemically effective, are largely free of side-effects, and have probably improved the prognosis for survival and morbidity. Further evidence is needed from cases of severe iron intoxication. © 1968, British Medical Journal Publishing Group. All rights reserved.