Pediatric Iron Toxicity Differential Diagnoses

Updated: Aug 04, 2020
  • Author: Christopher P Holstege, MD; Chief Editor: Stephen L Thornton, MD  more...
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Diagnostic Considerations

Iron poisoning can mimic other disease states. Without a history of ingestion, it may be mistaken for a viral or bacterial gastroenteritis. If a history of ingestion is known, clinicians should always inquire as to what else may have been accessible to the child, as other caustic agents (eg, acid or alkali exposures) could also produce a similar clinical picture, and large ingestions of certain medications can produce similar GI symptoms and a profound metabolic acidosis (eg, metformin)

Iron poisoning should remain in the differential for children with an unexplained anion gap metabolic acidosis (one of the "I"s of the MUDPILES mnemonic) [6] :

  • Methanol
  • Uremia
  • Diabetic ketoacidosis
  • Paraldehyde
  • Iron (or Isoniazid)
  • Lactic acidosis
  • Ethylene glycol
  • Salicylates

Differential Diagnoses