iron poisoning
Introduction
Introduction to iron poisoning Iron poisoning is not uncommon, mostly due to excessive consumption of ferrous sulfate. Infants can be seriously poisoned or even die due to oral administration of ferrous sulfate 40mg ~ 1.5g; larger children have been poisoned by 10 to 15 sugar-coated ferrous pills (0.3g per pill), but also due to cooking in iron pan Acidic fruit causes iron poisoning. Excessive injection of iron can cause severe poisoning. basic knowledge The proportion of illness: 0.0003%-0.0005% (more common in excessive iron supplement) Susceptible people: no specific population Mode of infection: non-infectious Complications: shock, renal failure
Cause
Cause of iron poisoning
Misuse of iron (82%)
Poisoned in life and work due to accidental misuse of large doses of iron. Infants can be seriously poisoned or even die due to oral administration of ferrous sulfate 40mg ~ 1.5g; larger children have been poisoned by 10 to 15 sugar-coated ferrous pills (0.3g per pill), but also due to cooking in iron pan Acidic fruit causes iron poisoning. Excessive injection of iron can cause severe poisoning.
Prevention
Iron poisoning prevention
1. Reasonable use of iron supplements. Dithiopropanol is banned when iron preparations are used. There are two active sulfhydryl groups in the molecule, which have a strong affinity with metals, can capture the metal that has been combined with the enzyme system in the tissue, form a non-toxic compound that is not easily decomposed, and is discharged from the urine to restore the activity of the enzyme system. Detoxification effect. In the treatment of metal poisoning, a sufficient amount of this product must be repeatedly administered so that the free metal is completely combined with dimercaptopropanol until it is discharged. The earliest antidote to Louise is now mainly poisoned by arsenic, mercury, locks and cockroaches.
2. When applying iron preparations, dithiopropanol is prohibited.
3. Production sites should adopt dust-proof measures to strengthen publicity and education and close dust sources.
Complication
Iron poisoning complications Complications, shock, renal failure
Iron poisoning has complications such as delayed shock and renal failure; infant poisoning can cause serious injury to the building.
1. Pathological state in which some or all of the kidney function is lost. According to the rapid onset of the attack, it is divided into acute and chronic. Acute renal failure is caused by a variety of diseases, causing the two kidneys to lose excretory function in a short time, referred to as acute renal failure. Chronic renal failure is a syndrome that consists of a group of clinical symptoms that arise from the development of chronic kidney disease caused by various causes to the advanced stage.
2. Rickets and osteomalacia are bone diseases caused by vitamin D deficiency and different clinical forms of different ages.
Symptom
Symptoms of iron poisoning Common symptoms Abdominal pain Liver failure Hepatic dysfunction Diarrhea Hypotension Nausea Kidney damage Hemosiderin Symptoms Leukocytosis Astragalus
Inadvertently taking a large amount of iron, the process of iron poisoning can be divided into five phases:
1 30 minutes after the accidental consumption of iron to 2 hours, due to the stimulation of iron on the gastrointestinal mucosa, local necrosis and hemorrhage, leading to hemorrhagic gastroenteritis, clinical manifestations of nausea, vomiting, abdominal pain, diarrhea, hematemesis, bloody stool Severe hypotension, shock and coma can occur, and this period lasts about 4 to 6 hours.
2 2 to 6 hours after the asymptomatic period, the patient's surface phenomenon is better, at this time iron accumulated in the mitochondria and various organs.
3 After taking a large amount of iron in the body for about 12 hours, due to iron damage caused by cell damage, hypoglycemia and metabolic acidosis occur, and there may be fever, leukocytosis and coma, and children develop delayed shock. Iron can be as high as 89.5 mol/L (500 g/dl) or more.
4 oral administration of iron 2 to 4 days after liver and kidney damage, liver enlargement, jaundice, abnormal liver function and even liver failure, hematuria, protein and cast in urine.
5 After 2 to 4 weeks of ingestion of iron, pyloric stenosis remains due to scar formation.
If you take a lot of iron for a long time, it may cause hemosiderosis in the lungs, liver, kidney, heart, pancreas, etc., and can lead to embolic lesions and fibrosis.
Examine
Iron poisoning inspection
The iron poisoning inspection includes the following inspection items:
Electrocardiogram, blood test, blood electrolyte test, blood biochemistry six tests, liver function test, renal function test.
Six tests of blood biochemistry are preliminary tests on human blood conditions, including 1, alanine aminotransferase, creatinine, urea nitrogen, serum glucose, triglycerides, and total cholesterol.
The urinary iron is positive, and the well can be quantitatively determined.
Diagnosis
Diagnosis and identification of iron poisoning
The clinical manifestations of iron poisoning can be misdiagnosed as diabetes, idiopathic cardiomyopathy, rheumatoid arthritis, degenerative arthritis, alcoholic cirrhosis, hypothyroidism and many other diseases. To improve the vigilance of iron poisoning tendency in such patients, and to conduct screening tests for SI, serum ferritin and transferrin saturation, the differential diagnosis is not difficult. The disease should be differentiated from diseases with excessive iron overload.
