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Acute Iron poisoning, Suicide, Autopsy, Histopathology
Acute iron toxicity in adolescents and adults is rare and usually results from intentional ingestion in suicidal attempts. Only a handful of cases of acute iron toxicity with clinical and autopsy-pathological findings have been previously reported in the literature. We report five fatal cases of acute iron toxicity in adolescent females died with suicidal ingestion of 20-60 iron or iron-folic. Cases were reported for autopsy in the year 2015 to 2023. Autopsies were performed and tissue samples were preserved for toxicological analysis and histopathological studies for accurate identification of the cause of death. Common autopsy findings were edema, multiple confluent patechial hemorrhages in internal organs with pale parenchyma. Microscopic findings revealed, edema in internal organs, surface mucosal necrosis, erosion of stomach and intestinal mucosa with lymphoid aggregates and hemosiderin pigments deposition in sub-mucosa, diffuse hepatic, portal necrosis and focal hemorrhages in sinusoids and granular hemosiderin pigments deposit in the hepatocytes, diffuse acute tubular necrosis, intravascular hemorrhages and hemosiderin pigments depositions in glomeruli and renal
tubules, dilated, congested blood vessels, parenchymal necrosis, pigments depositions and lymphoid aggregates in spleen, lung parenchyma with diffuse necrosis and pigments depositions, brain cell necrosis irregular cellular aggregates, congested blood vessels and foci with brown hemosiderin pigments depositions in stroma and around blood vessels. In all cases, the viscera were found positive for iron preparations. Present report clearly described specific gross and histopathological features of acute iron poisoning. Though essential micronutrient its knowledge as a poison and monitored and supervised use is the key to prevent iron toxicity.
2. Iron [Internet]. Linus Pauling Institute. 2023 [cited 2023Mar4]. Available from:
3. UpToDate [Internet]. Uptodate.com. [cited 2023 Mar 6]. Available from:
4. Robotham JL, Lietman PS. Acute iron poisoning. A review. Am J Dis Child. 1980;134:875–9. https://doi.org/10.1001/archp edi.1980.02130210059016.
5. Sane MR, Malukani K, Kulkarni R, Varun A. Fatal iron toxicity in an adult: clinical profile and review. Indian J Crit Care Med. 2018;22(11):801–3.
6. Yu D, Giffen MA Jr. Suicidal iron overdose: A case report and review of literature. J Forensic Sci [Internet]. 2021;66(4):1564–9. Available from: http://dx.doi.org/10.1111/1556-4029.14701
7. Baranwal AK, Singhi SC. Acute iron poisoning: Management guidelines. Indian Pediatr. 2003;40:534–40
8. Mahesh KM, Rani R. CASE OF IRON POISONING-CASE REPORT. International Journal of Basic and Applied Medical Sciences. 2014 Vol. 4 (3), pp. 101-103.
9. Daram SR and Hayashi PH. Acute liver failure due to iron overdose in an adult. Southern Medical Journal. 2005; 98: 241-44.
10. Pestaner JP, Ishak KG, Mullick FG, Centeno JA. Ferrous Sulphate Toxicity: a Review of autopsy findings. Biol Trace Elem Res.1999;69(3):191-8.https://doi.org/10.1007/BF02783871.
11. 7. Pillay VV. Modern Medical Toxicology. 4th ed. New Delhi: Jaypee Brothers Medical Publishers; 2013. p. 97. [Google Scholar]
12. Banner W, Tong TG. Iron poisoning. Pediatr Clin North Am 1986;33:393-409.
13. Gleason WA, deMello DE, deCastro FJ, Connors JJ. Acute hepatic failure in severe iron poisoning. J Pediatr 1979;95: 138-40.
14. Eriksson F, Johansson SV, Mellstedt H, Stranberg O, Wester PO. Iron intoxication in two adult patients. Acta Med Scand 1974; 196:231-6.
15. Evensen SA, Forde R, Opedal I, Stormorken H. Acute iron intoxication with abruptly reduced levels of vitamin K-dependent coagulation factors. Scand J Haematol 1982; 29:25-30.
16. Tenenbein M, Littrnan C, Stimpson RE. Gastrointestinal pathology in adult iron overdose. J Toxicol Clin Toxicol1990;28:311-20.