Bosse G M
University of Louisville School of Medicine, Department of Emergency Medicine, KY 40292.
J Toxicol Clin Toxicol. 1995;33(2):135-40. doi: 10.3109/15563659509000463.
For the four year period 1990-1993, we retrospectively reviewed all cases of iron ingestion reported to a regional poison control center that had serum iron levels in the 300-500 micrograms/dL range and did not receive deferoxamine. A total of 32 patients did not undergo deferoxamine therapy or challenge testing. The mean age was 6.7 years (range five months to 21 years). The mean serum iron level was 372.8 micrograms/dL (range 301-487 micrograms/dL). Ten patients (31.3%) were asymptomatic. Symptoms included vomiting in 18 (56.3%), diarrhea in six (18.8%), lethargy in one (3.1%), and transient hypotension in one patient (3.1%). No patients presented with grossly bloody emesis or stool. Fifteen patients (46.9%) were hospitalized for at least one day. Seventeen (53.1%) were treated and released from the emergency department. All 32 patients recovered without sequelae. A conservative approach without deferoxamine therapy or challenge should be considered when serum iron levels are in the 300-500 micrograms/dL range in asymptomatic patients, as well as in those with self-limited, non-bloody emesis or diarrhea without other symptoms.
在1990年至1993年的四年期间，我们回顾性地研究了向一个地区毒物控制中心报告的所有铁摄入病例，这些病例的血清铁水平在300 - 500微克/分升范围内，且未接受去铁胺治疗。共有32例患者未接受去铁胺治疗或激发试验。平均年龄为6.7岁（范围为5个月至21岁）。平均血清铁水平为372.8微克/分升（范围为301 - 487微克/分升）。10例患者（31.3%）无症状。症状包括呕吐18例（56.3%）、腹泻6例（18.8%）、嗜睡1例（3.1%）和1例患者出现短暂低血压（3.1%）。没有患者出现明显的血性呕吐物或粪便。15例患者（46.9%）住院至少1天。17例（53.1%）在急诊科接受治疗后出院。所有32例患者均康复且无后遗症。对于无症状患者以及有自限性、非血性呕吐或腹泻且无其他症状的患者，当血清铁水平在300 - 500微克/分升范围内时，应考虑采用不进行去铁胺治疗或激发试验的保守方法。
