iron intoxication in children by dr praythiesh bruce mbbs

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iron intoxication in children by dr praythiesh bruce mbbs

  1. 1. PEDIATRICS SEMINAR PRESENTATIONTOPIC;IRON INTOXICATION IN CHILDREN <br /> BY<br />M.S.PRAYTHIESH BRUCE,<br />FINAL MBBS,SMIMS,<br />KULASEKARAM<br />
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  3. 3. IRON INTOXICATION IN CHILDREN<br />IRON IS A ESSENTIAL NUTRIENT THAT IS COMMON CONTENT OF VITAMIN PREPARATIONS AND TONICS<br />IRON POISONING IS A PEDIATRIC EMERGENCY<br />ONE OF THE TOP 10 SUBSTANCES INGESTED BY CHILDREN LESS THAN 5 YEARS<br />CHRONIC IRON INTOXICATION OCCUR DUE TO REPEATED BLOOD TRANSFUSION AND THALASSEMMIA <br />
  4. 4. ACCIDENTAL POISONING OF IRON IN CHILDREN<br />OCCUR DUE TO ;<br />FREQUENT IRON SUPPLEMENTS FOUND IN MANY HOMES<br />UNAWARENESS OF PEOPLE THAT IRON CAN BE DANGEROUS<br />ATTRACTIVENESS OF IRON TABLETS<br />ILLETERACY AND CARELESSNESS OF PATIENT<br />
  5. 5. PATHOPHYSIOLOGY OF IRON POISONING<br />
  6. 6. TOXIC DOSES<br />LOWEST LETHAL DOSE OF IRON IS 600MG<br />20MG/KG SUB TOXIC<br />20-60MG/KGBODY WEIGHT –MILD SYMPTOMS<br />>60MG/KG BODY WEIGHT-POTENTIALLY LETHAL <br />
  7. 7. CLINICAL FEATURES<br />VOMITING,ABDOMINAL PAIN<br />CRAMPS,HEMATEMESIS,DIARRHOEA,CIRCULATORY FAILURE,JAUNDICE(2-4 DAYS LATER)<br />
  8. 8. CLINICAL FEATURES OF IRON I INTOXICATION<br />GASTROINTESTINAL STAGE;30MIN-2HOURS<br />APPARENT RECOVERY;2-6HOURS<br />CIRCULATORY FAILURE;12 HOURS<br />HEPATIC NECROSIS;2-4 DAYS<br />GASTRIC SCARRING-2-4 WEEKS<br />
  9. 9. DEFINITIVE TREATMENT OF IRON INTOXICATION<br />CHELATING AGENT;DESFERRIOXAMINE<br />INDICATIONS;<br />LETHARGHY,TACHYPNEA,TACHYCARDIA<br />HYPOTONIA <br />FREE SERUM IRON IS MORE THAN 50UG/DL<br />TOTAL SERUM IRON >350UG/DL<br />LEUCOCYTE COUNT MORE THAN 15,000CUMM<br />SERUM GLUCOSE>150MG/DL<br />
  10. 10. ROUTE AND DOSAGE OF DESFERRIOXAMINE . . <br />ACUTE CASES IV INFUSION<br />LESS SEVERE CASES IM<br />I5MG/KG/HR IV AND 50MG/KG GIVEN EVERY 4 HOURS IM<br />TOTAL DOSE SHOULD NOT EXCEED 6GM IV OR IM<br />PREPARATION AVAILABLE;POWDER FORM IN VIAL 5OOMG WHICH DILATED IN WATER FOR INJECTION TO HAVE 10 %SOLUTION<br />SOLUTION IS DILUTED IN 0.8%SALINE IN 5%DEXTROSE <br /> FOR CONTINOUS IV ADMINISTRATION<br />
  11. 11. INVESTIGATIONS;<br />PLAIN XRAY OF ABDOMEN<br />FREE SERUM IRON>50MG/DL<br />TOTAL SERUM IRON>350MG/DL<br />LEUCOCYTOSIS<br />
  12. 12. MANAGEMENT OF IRON INTOXICATION IN CHILDREN<br />EMESIS WITH SYRUP IPECAC<br />GASTRIC LAVAGE<br />SUPPORTIVE AND SYMPTOMATIC TREATMENT<br />CHELATION THERAPHY<br />DIALYSIS WITH CHELATION <br />VERY SEVERE CASES ;EXCHANGE TRANSFUSION<br />CHARCOAL HEMOPERFUSION WITH SIMULTANEOUS CHELATION<br />
  13. 13. THANK YOU<br />

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