Fulminant Hepatic Failure Following Intentional Iron Overdose—A Case Report

IF 0.6 Q3 MEDICINE, GENERAL & INTERNAL

Clinical Case Reports Pub Date : 2025-04-30 DOI:10.1002/ccr3.70476

Hrithik Dakssesh Putta Nagarajan, Ram Vivek Ramamoorthy, Naveen Vishwanath, Miruthula Murugan, Balakrishnan Kamaraj, Shiva Jeyaprakash Narayan Balamurugan, Shubham Kumar, Shilpa Gaidhane, Sanjit Sah, Prakasini Satapathy, Rachana Mehta, Amogh Verma

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Abstract

Intentional iron overdose in adults is a rare but formidable clinical challenge, often complicated by delayed presentation and a concealed history of ingestion. We report the case of a 21-year-old male who presented 4 days after consuming large quantities of ferrous sulfate tablets. The initial nonspecific gastrointestinal symptoms progressed to severe jaundice, encephalopathy, and coagulopathy, and the diagnosis was confounded by the patient's denial of suicidal ingestion. By the time iron toxicity was identified, the therapeutic window for early decontamination or parenteral chelation had been passed. Supportive care, including advanced extracorporeal therapies, facilitated hepatic and renal recovery. This case highlights the importance of high clinical suspicion, thorough history taking, and the potential role of salvage therapies in severe late-presenting iron poisoning.

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故意铁过量致暴发性肝衰竭1例报告

成人故意铁过量是一种罕见但可怕的临床挑战，通常因延迟表现和隐藏的摄入史而复杂化。我们报告的情况下，一个21岁的男性谁提出4天后，消耗大量硫酸亚铁片。最初的非特异性胃肠道症状进展为严重黄疸、脑病和凝血功能障碍，并且由于患者否认自杀性摄入而混淆了诊断。到确定铁毒性时，早期去污或肠外螯合的治疗窗口期已过。支持治疗，包括先进的体外治疗，促进了肝脏和肾脏的恢复。本病例强调了高度临床怀疑、彻底的病史记录和抢救治疗对晚期严重铁中毒的潜在作用的重要性。

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来源期刊

Clinical Case Reports MEDICINE, GENERAL & INTERNAL-

自引率

14.30%

发文量

1268

审稿时长

13 weeks

期刊介绍： Clinical Case Reports is different from other case report journals. Our aim is to directly improve global health and increase clinical understanding using case reports to convey important best practice information. We welcome case reports from all areas of Medicine, Nursing, Dentistry, and Veterinary Science and may include: -Any clinical case or procedure which illustrates an important best practice teaching message -Any clinical case or procedure which illustrates the appropriate use of an important clinical guideline or systematic review. As well as: -The management of novel or very uncommon diseases -A common disease presenting in an uncommon way -An uncommon disease masquerading as something more common -Cases which expand understanding of disease pathogenesis -Cases where the teaching point is based on an error -Cases which allow us to re-think established medical lore -Unreported adverse effects of interventions (drug, procedural, or other).