Acute respiratory distress syndrome in children with acute iron poisoning : the role of intravenous desferrioxamine

The acute respiratory distress syndrome is a rare but potentially fatal complication of severe acute iron poisoning and its pathogenesis has been linked with direct and indirect iron toxicity as well as the use of the chelator drug desferrioxamine. We report a case of severe acute respiratory decompensation in a child treated according to the current protocol for chelation therapy and discuss its implications. We believe that the efficacy and safety of chelation therapy in severe acute iron poisoning may be improved by targeting the initial high levels of readily chelatable serum iron with adequate doses of desferrioxamine without prolonging its use unnecessarily.