Iatrogenic Intravenous Iron Sucrose Intoxication in a Woman: A Case Report

Abstract

This report describes a case of iatrogenic exogenous ferric hydroxide sucrose intoxication in a 44-year-old obese woman with a history of vaginal bleeding under investigation for myomatosis. It is suspected that, due to a prescription misinterpretation, 10 ampoules (100 mg/5 mL each) of the medication were injected into the patient. One hour after the infusion, she experienced dyspnea, facial edema, tachycardia, and erythema. Initially treated with corticosteroids, she developed hypotension and sweating, and was transferred to the Intensive Care Unit (ICU). Her blood pressure improved without the need for vasoactive drugs, but she presented dark urine with subtle worsening of renal function and a serum iron level of 831 µg/dL (reference: 50-175 µg/dL). She was managed with deferoxamine 15 mg/kg (1,500 mg) over 6 hours, and then 15 mg/kg over 18 hours by continuous infusion. Twenty-four hours after the incident, the patient's serum iron level was 393 µg/dL, and on the third day, it was 50 µg/dL. She was discharged after one week, asymptomatic and with complete improvement of renal function, without liver damage. This report aims to contribute to the literature on the subject, since exogenous oral iron poisoning is quite prevalent and serious, but intravenous iron poisoning still lacks specific literature.