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Various toxicities: case report A woman in her 20s [exact age at reaction onset not stated] developed oedematous mucosa, bezoar and drug toxicity following an intentional overdose of ferrous-fumarate in a suicide attempt. The woman was admitted 3 hours after ingesting 300 ferrous-fumarate tablets (iron C-tablets containing 330mg ferrous fumarate=100mg elementary iron) equivalent to an iron dose of 400 mg/kg with a suicidal intent. At the time of admission, she had no somatic symptoms and her plasma ferritin concentration was 82 µmol/L. Abdominal x-ray revealed large amounts of ferrousfumarate tablets in ventricle. The woman started receiving deferoxamine mesylate as an antidote and gastroscopy was performed for decontamination. Findings revealed an oedematous mucosa and a large bezoar consisting of a thick mass of food remnants and partially dissolved ferrous-fumarate tablets, most of them were extracted. Plasma ferritin levels were then dropped to 49 µmol/L. Repeat abdominal xray revealed residual ferrous-fumarate tablets in the ventricle and spread into the small intestine. Therefore a repeat gastroscopy with evacuation of the residual bezoar was performed. She started receiving unspecified polyethylene-glycol [macrogol] laxatives to accelerate bowel emptying. She was then transferred to an intensive care unit for clinical observation at an another hospital. Intestinal lavage was continued for 2 days. Later, she was discharged to a psychiatric unit. Subsequently she remained free of signs of complications or organ damage. Petersen SM, et al. [Multidisciplinary treatment of acute iron poisoning due to suicide attempt]. [Danish]. Ugeskrift for Laeger 182: No. 46, 9 Nov 2020 [Danish; summarised 803519826 from a translation]

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Reactions 12 Dec 2020 No. 1834