Near-fatal ferrous sulfate poisoning: A case report of successful conservative management

Rationale: Acute iron poisoning is commonly seen in a pediatric population caused by accidental ingestion of iron syrups. We describe a case of iron poisoning who presented to the hospital following intentional near-fatal ingestion of ferrous sulfate. Patient’s Concern: A 14-years-old previously healthy female patient presented to the emergency department with a history of an intentional overdose of 80 ferrous sulfate tablets. Diagnosis: Ferrous sulfate poisoning. Interventions: The patient developed acute fulminant liver failure 24 h after of the overdose. She was managed conservatively, mainly with deferoxamine and N-acetylcysteine while awaiting transfer to a liver transplant facility. Outcomes: The patient responded well to medical therapy and was discharged on the 9th day of intensive care unit admission. Lessons: This case highlights the patient’s successful recovery with prompt conservative therapy. Severe iron toxicity can be treated with early use of deferoxamine and N-acetylcysteine where a liver transplant facility is not available.