Coma, hypotension, hypoventilation, reduced muscle tone and diminished reflexes. Pupils are normal in size.
Dysphagia, dysphoria, trismus, oculogyric crisis.
Gastric lavage is a priority.Serum iron is estimated at presentation.Gastrointestinal symptoms are common with:
Symptoms of intestinal haemorrhage.
Perforation of the bowel is expected. Severe hypotension may occur.
The next stage of poisoning may give the paediatrician a false sense of security when the patient appears to improve. This is the stage of the iron being absorbed and accumulated into the mitochondria.
Cellular damage occurs and features of hepatic toxicity with a metabolic acidosis and hypoglycaemia develop.
Severe hepatic necrosis results in jaundice, deranged liver function and clotting abnormalities.
Treatment = IV desferrioxamine and supportive treatment.
colicky abdominal pain
failure to thrive with pallor from anaemia.
If severe may present with encephalopathy (drowsiness, convulsions and coma, with papilloedema).