A 3-year-old ingests an unknown quantity of iron tablets. He presents 4 hours later with haematemesis and metabolic acidosis. Serum iron is 650 μg/dL. Which of the following is the MOST appropriate chelation therapy?
- A EDTA IV infusion
- B Dimercaprol (BAL) IM injection
- C Deferoxamine IV infusion at 15 mg/kg/h ✓
- D D-penicillamine orally
Correct answer: C. Deferoxamine IV infusion at 15 mg/kg/h
Explanation
Deferoxamine is the specific chelator for iron poisoning. When serum iron exceeds 500 μg/dL or the child has systemic toxicity (haematemesis, metabolic acidosis), IV deferoxamine at 15 mg/kg/h (max 80 mg/kg/day) is indicated. EDTA is used for lead poisoning. BAL (dimercaprol) chelates arsenic, mercury, and gold, and is contraindicated in iron poisoning. D-penicillamine is used for copper (Wilson's disease) and rheumatoid arthritis.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.