International Journal of Medical Laboratory Research (IJMLR)

IRON POISONING WITH ANALYTICAL ASPECTS AND ITS MANAGEMENT

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AK Jaiswal, N Shubhangi, A Dey, DK Sharma, T Millo, SK Gupta

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ABSTRACT: Iron is a naturally occurring element found in the nature. It is denoted by the symbol Fe and has an atomic number 26. Iron is one of the most common metals occurring on earth. It occurs in a variety of oxidation states.Out of all the states ferrous (II) and ferric (III) are the most common states and ferrous iron is absorbed better in the body than ferric iron.This is the reason it is used in many iron supplements. Iron is found in many over-the-counter (OTC) multivitamins. Iron toxicity from intentional or accidental ingestion is a common poisoning. Life-threatening toxicity is associated with pediatric ingestion of potent adult preparations, such as prenatal vitamins. Serious iron ingestion in adults is usually associated with suicide attempts. The exposure to iron can be in various forms including metal, salts (ferrous sulfate) and organic compounds. Organs that are affected by iron toxicity are pancreas, liver, kidneys, central nervous system and joints. The clinical features of iron poisoning along with the appropriate diagnosis has been discussed in this paper. The hospitalization and post-hospitalization management would help in the proper care of the patient along with the treatment that canbe done along with analytical techniques like Inductively coupled plasma-mass spectrometry (ICP-MS), Atomic absorption spectroscopy (AAS) and Voltammetry.

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KEY WORDS: Iron toxicity, Metal poisoning, Inductively coupled plasma-mass spectrometry (ICP-MS), Atomic absorption spectroscopy (AAS).

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REFERENCES:

1. SS.Clinical Chemistry and Chemical Toxicology of Metals, 2nd ed. Elsevier, North Holland; 1977:308.

2. Lyon’s Medical Jurisprudence & toxicology, 11thed. Delhi Law House Publishing Co. Ltd, New Delhi Law House Publishing Co. Ltd, New Delhi, 2005:1155.

3. Parikh’s Textbook of Medical Jurisprudence, Forensic Medicine & Toxicology, 6th ed. CBS Publishers & Distributors, New Delhi, 2005:9.15

4. Zhang D, Meyron-Holtz E, Rouault TA : Renal iron metabolism: transferrin iron delivery and the role of iron regulatory proteins. J Am Soc Nephrol 2007; 18: 401-406.

5. Smith CP, Thevenod F: Iron transport and the blood. BiochimBiophys Acta 2009; 1790:724 – 730.

6. Schulz M., Schmoldt A: Therapeutic and toxic blood concentrations of more than 800 drugs and other xenobiotics. Pharmazie 2003 ; 58: 447-474.

7. Jaiswal A.K. and Millo T. Handbook of Forensic Analytical Toxicology, 1st ed. New Delhi: Jaypee brothers medical publishers (P) ltd; 2014.

8. DFS Manual of Toxicology, Selective & Scientific Publisher, 1st ed. New Delhi, 2005: 94-99.

9. Comprehensive Medical Toxicology, 2th ed. VV Pillay. Paras Medical Publisher, Hyderabad, 2008:135—137.

10. Sharma B.R, Forensic Science in Criminal Investigation and Trials 3rded. Universal Law Publishing Co. Ltd, New Delhi, 2005:94-99.

11. Tiwari SN. Manual of Toxicology Forensic Science Laboratory, 1st edn. Agra 1976; 58.

12. Benson BL, Cheney K. Survival after severe iron poisoning treated with high dose Deferoxamine therapy. Vet Human Toxicology.1992; 34.

13. Tennenbien M, Yatskoff BW. The total iron binding capacity in iron poisoning: Is it useful? American Journal of Diseases in Child. 1991; 145:437—439.

14. Banner W, Vernon DD, Ward R, Sweeley J, Dean JM. Vet Human Toxicology. 1988; 30:755.