SUICIDAL ACUTE IRON POISONING IN ADOLESCENT FEMALES – A CASE SERIES

Abstract

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.