{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T18:40:08Z","timestamp":1746384008728,"version":"3.40.4"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Cases of severe iron toxicity have become increasingly rare; most cases are intentional ingestions by late adolescents and adults who present within 12 hours of ingestion. We present a case of an adolescent girl with metabolic acidosis, hypoglycemia, obtundation, and liver and renal failure of undifferentiated etiology who was eventually discovered to have overdosed on ferrous sulfate tablets 4 days before arrival. The diagnosis was made because the patient had an elevated transferrin concentration in the setting of a minimally elevated serum iron concentration and faint radio-opacities on abdominal plain film imaging. This case presents many diagnostic challenges and treatment dilemmas and is a rare report of survival in delayed presentation of severe toxicity.<\/jats:p>","DOI":"10.1097\/pec.0000000000002430","type":"journal-article","created":{"date-parts":[[2021,4,20]],"date-time":"2021-04-20T03:47:29Z","timestamp":1618890449000},"page":"e269-e271","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Hard as Iron"],"prefix":"10.1097","volume":"37","author":[{"given":"Shannon S.","family":"Rickner","sequence":"first","affiliation":[{"name":"Division of Medical Toxicology, Department of Emergency Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sing-Yi","family":"Feng","sequence":"additional","affiliation":[{"name":"Division of Medical Toxicology, Department of Emergency Medicine, Parkland Memorial Health & Hospital System, University of Texas Southwestern Medical Center, Dallas, TX."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2021,4,23]]},"reference":[{"key":"bib1-20250504","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1097\/PEC.0b013e3182302604","article-title":"Iron poisoning: a literature-based review of epidemiology, diagnosis, and management","volume":"27","year":"2011","journal-title":"Pediatr Emerg Care"},{"key":"bib2-20250504","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1177\/096032718700600407","article-title":"Accidental poisoning in childhood: a multicentre survey. 2. 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