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Chen CB, Chugh S, Rao D. Iron Pill-Induced Gastritis in a Pediatric Patient Taking Ferrous Sulfate Tablets. J Pediatr Pharmacol Ther 2024; 29:425-428. [PMID: 39144394 PMCID: PMC11321807 DOI: 10.5863/1551-6776-29.4.425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 01/23/2024] [Indexed: 08/16/2024]
Abstract
Iron supplementation is frequently used in the treatment of iron deficiency anemia in the pediatric population. We describe a case of an 11-year old male who developed adverse side effects following treatment with oral ferrous sulfate tablets for 2 months. The diagnosis was made following findings of iron deposition on histology obtained during endoscopy. The iron supplementation was changed from tablet to liquid form, and repeat endoscopy 4 months following initial diagnosis showed resolution of the histologic findings of iron pill-induced gastritis.
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Affiliation(s)
- Charles B. Chen
- Division of Gastroenterology (CBC), Department of Pediatrics, University of Missouri School of Medicine, Columbia, MO
| | - Shreeya Chugh
- Division of Gastroenterology, Hepatology & Nutrition (SC), Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA
| | - Deepthi Rao
- Department of Pathology and Anatomical Sciences (DR), University of Missouri, Columbia, MO
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2
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Sarwate M, Khaitan N, Alpert L, Tavberidze N, Zhang W, Panarelli N, Hu S. Gastric Glandular Siderosis but not Lamina Propria Siderosis is Associated With High Serum Ferritin Levels. Am J Surg Pathol 2023; 47:1052-1058. [PMID: 37357943 DOI: 10.1097/pas.0000000000002080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Three histologic patterns of gastric siderosis (GS) are described: pattern A (predominantly in lamina propria stromal cells-gastric lamina propria siderosis [GLPS]), pattern B (mostly extracellular crystalline iron) and pattern C (predominantly in glandular epithelium-gastric glandular siderosis [GGS]). This study aimed to analyze the association of GGS with clinicopathologic features using 3 cohorts. Cohort #1 consisted of 76 gastric siderosis cases. Upon classifying the cases into 3 groups by percentage of glandular involvement (negative, 1% to 5%, ≥5% GGS), the degree of GGS was positively associated with serum ferritin levels ( P =0.002), transferrin saturation ( P =0.003), and history of blood transfusion ( P =0.009). After excluding cases with coarse extracellular crystalline iron, cohort #1 was reclassified into 3 groups by degree of GLPS (no, rare [discernible at ×20 or ×40], overt [readily visible at low power]). The degree of GLPS was positively correlated with oral iron pill use ( P =0.01), but not serum ferritin levels or transferrin saturation. Cohort #2 contained 31 gastric samples from patients with hereditary hemochromatosis, most received phlebotomy treatment. GGS was identified in 2 (6.4%) patients; both had high ferritin levels. Cohort #3 included 38 gastric samples from patients with cirrhosis. Three (8%) cases showed GGS; serum ferritin level was available for 1 case and was elevated. These results indicate that GGS is associated with systemic iron overload, while GLPS is correlated with oral iron pill use. The identification of GGS, especially when it's ≥5%, should trigger further workup for potential systemic iron overload and underlying etiologies.
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Affiliation(s)
- Mrinal Sarwate
- Department of Pathology, Cleveland Clinic, Cleveland, OH
| | - Neha Khaitan
- Department of Pathology, Cleveland Clinic, Cleveland, OH
| | - Lindsay Alpert
- Department of Pathology, University of Chicago Medicine, Chicago, IL
| | - Nika Tavberidze
- Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, WI
| | - Wei Zhang
- Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, WI
| | | | - Shaomin Hu
- Department of Pathology, Cleveland Clinic, Cleveland, OH
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3
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Correia C, Gravito-Soares E, Gravito-Soares M, Cipriano MA, Amaro P. Iron pill-induced gastritis: an unrecognized side effect of iron-deficiency anemia. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2023; 115:100. [PMID: 35748462 DOI: 10.17235/reed.2022.9005/2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Iron-deficiency anemia is a prevalent condition usually treated with iron supplementation. Iron pill-induced gastritis is an under-recognized, albeit serious potential complication of iron pill ingestion in the upper gastrointestinal tract. This entity must be identified by healthcare providers who prescribe iron. The diagnosis of this unusual drug-induced disease is based on endoscopic findings and histopathological examination, because the clinical symptoms are vague and non-specific. Herein we report a case of a 79-year-old woman with iron-deficiency anemia taking oral ferrous sulfate with multiple congestive and eroded polypoid lesions. Histology showed an H. pylori-negative erosive gastritis with iron deposition, confirming the diagnosis of iron pill-induced gastritis. The aim of this report is to highlight that iron pill-induced gastritis is an under-diagnosed entity that must be kept in mind when patients undergo chronic iron-pill therapy because it can lead to serious complications of the upper gastrointestinal tract.
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Affiliation(s)
- Catarina Correia
- Gastrenterology, Centro Hospitalar e Universitário de Coimbra, Portugal
| | | | | | | | - Pedro Amaro
- Gastrenterology, Centro Hospitalar e Universitário de Coimbra, Portugal
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4
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Wael Mohamed M, Althahabi R, Abubaker F, Sharif O. An Incidental Finding of Gastric and Duodenal Pseudomelanosis: A Case Report. Case Rep Gastroenterol 2022; 16:264-269. [PMID: 35702444 PMCID: PMC9149464 DOI: 10.1159/000524192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 03/14/2022] [Indexed: 11/20/2022] Open
Abstract
Pseudomelanosis of the upper gastrointestinal tract is a rare diagnosis of undetermined significance, most commonly affecting the duodenum. Endoscopically, it is characterized by dark spickled pigmentation . Its development has been linked to certain conditions and medications. Involvement of the stomach is extremely rare with very few cases reported in the literature to date. We report an 85-year-old male who is known to have type 2 diabetes mellitus, dyslipidemia, iron deficiency anemia, and chronic kidney disease who underwent an esophagogastroduodenoscopy for evaluation of upper gastrointestinal bleeding and was found to have gastric and duodenal pseudomelanosis confirmed by biopsy. It is an extremely rare benign condition, but metastatic melanoma has to be ruled out, as was done in this case.
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Affiliation(s)
- Mohamed Wael Mohamed
- Department of Internal Medicine, King Hamad University Hospital, Al-Muharraq, Bahrain
| | - Rawan Althahabi
- Department of Internal Medicine, King Hamad University Hospital, Al-Muharraq, Bahrain
| | - Faisal Abubaker
- Department of Gastroenterology, Hepatology and Endoscopy, King Hamad University Hospital, Al-Muharraq, Bahrain
| | - Omar Sharif
- Head of Department of Gastroenterology, Hepatology and Endoscopy, King Hamad Univer-sity Hospital, Al-Muharraq, Bahrain
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5
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Grillo F, Campora M, Carlin L, Cornara L, Parente P, Vanoli A, Remo A, Migliora P, Roberto F, Fassan M, Mastracci L. "Stranger things" in the gut: uncommon items in gastrointestinal specimens. Virchows Arch 2021; 480:231-245. [PMID: 34599376 PMCID: PMC8986674 DOI: 10.1007/s00428-021-03188-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/05/2021] [Accepted: 08/11/2021] [Indexed: 12/14/2022]
Abstract
Organic (such as parasites or vegetable remnants) and inorganic substances may be encountered during routine pathology diagnostic work up of endoscopic gastrointestinal biopsy samples and major resections, causing possible diagnostic conundrums for the young and not so young pathologists. The main aim of this review is the description of the most frequent oddities one can encounter as foreign bodies, in gastrointestinal pathology, on the basis of the current literature and personal experience. The types of encountered substances are divided into four principal categories: parasites (helminths such as Enterobius vermicularis, Strongyloides, Schistosoma, and Anisakis, and protozoa such as Entamoeba, Giardia and some intestinal coccidia); drugs and pharmaceutical fillers (found as deposits and as bystanders, innocent or not); seeds (possibly confused with worms) and plant remnants; pollutants (secondary to post-resection or post-biopsy contamination of the sample). An ample library of images is provided in order to consent easy referencing for diagnostic routine.
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Affiliation(s)
- Federica Grillo
- IRCCS Ospedale Policlinico San Martino, Anatomic Pathology Unit, Genova, Italy
- Anatomic Pathology, Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, Largo Rosanna Benzi 10, 16132, Genova, Italy
| | - Michela Campora
- Anatomic Pathology Section, S. Chiara Hospital, Trento, Italy
| | - Luca Carlin
- Anatomic Pathology, Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, Largo Rosanna Benzi 10, 16132, Genova, Italy
| | - Laura Cornara
- Department for the Earth, Environment and Life Sciences (DiSTAV), University of Genoa, Genoa, Italy
| | - Paola Parente
- Pathology Unit, Fondazione IRCCS Ospedale Casa Sollievo Della Sofferenza, San Giovanni Rotondo, FG, Italy
| | - Alessandro Vanoli
- Anatomic Pathology Unit, Department of Molecular Medicine, University of Pavia, and IRCCS San Matteo Hospital, Pavia, Italy
| | - Andrea Remo
- Pathology Unit, Service Department, ULSS9 "Scaligera", Verona, Italy
| | - Paola Migliora
- Clinical Cytopathology Service and Pathology Institute of Locarno, Locarno, Switzerland
| | - Fiocca Roberto
- IRCCS Ospedale Policlinico San Martino, Anatomic Pathology Unit, Genova, Italy
- Anatomic Pathology, Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, Largo Rosanna Benzi 10, 16132, Genova, Italy
| | - Matteo Fassan
- Surgical Pathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
- Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Luca Mastracci
- IRCCS Ospedale Policlinico San Martino, Anatomic Pathology Unit, Genova, Italy.
- Anatomic Pathology, Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, Largo Rosanna Benzi 10, 16132, Genova, Italy.
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6
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McCormick R, Sim M, Dawson B, Peeling P. Refining Treatment Strategies for Iron Deficient Athletes. Sports Med 2020; 50:2111-2123. [PMID: 33057935 DOI: 10.1007/s40279-020-01360-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Iron deficiency (ID) is a prevailing nutritional concern amongst the athletic population due to the increased iron demands of this group. Athletes' ability to replenish taxed iron stores is challenging due to the low bioavailability of dietary sources, and the interaction between exercise and hepcidin, the primary iron-regulatory hormone. To date, copious research has explored the link between exercise and iron regulation, with a more recent focus on optimising iron treatment applications. Currently, oral iron supplementation is typically the first avenue of iron replacement therapy beyond nutritional intervention, for treatment of ID athletes. However, many athletes encounter associated gastrointestinal side-effects which can deter them from fulfilling a full-term oral iron treatment plan, generally resulting in sub-optimal treatment efficacy. Consequently, various strategies (e.g. dosage, composition, timing) of oral iron supplementation have been investigated with the goal of increasing fractional iron absorption, reducing gastric irritation, and ultimately improving the efficacy of oral iron therapy. This review explores the various treatment strategies pertinent to athletes and concludes a contemporary strategy of oral iron therapy entailing morning supplementation, ideally within the 30 min following morning exercise, and in athletes experiencing gut sensitivity, consumed on alternate days or at lower doses.
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Affiliation(s)
- Rachel McCormick
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, WA, Australia. .,The Western Australian Institute of Sport, Mt Claremont, WA, Australia.
| | - Marc Sim
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Medical School, Royal Perth Hospital Unit, The University Western Australia, Perth, WA, Australia
| | - Brian Dawson
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, WA, Australia
| | - Peter Peeling
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, WA, Australia.,The Western Australian Institute of Sport, Mt Claremont, WA, Australia
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7
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Motwani K, Rubin J, Yfantis H, Willard M. Iron pill induced gastritis causing severe anemia. Clin J Gastroenterol 2020; 13:732-735. [PMID: 32468501 DOI: 10.1007/s12328-020-01141-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 05/19/2020] [Indexed: 01/28/2023]
Abstract
Iron supplementation is ubiquitously prescribed and considered a benign means of therapy. However, side effects such as iron pill gastritis can be life threatening prompting discontinuation. We describe a case of a 71-year-old man who presents with severe iron deficiency anemia on oral iron therapy. Esophagogastroduodenoscopy revealed mucosal injury in the fundus, including erythema and ulceration. Biopsy of the area was significant for pill debris. After switching to intravenous iron supplementation, his gastric mucosa healed and anemia improved. This case demonstrates the rare life-threatening side effect of iron pills causing corrosive mucosal damage and significant anemia from gastrointestinal bleeding.
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Affiliation(s)
- Kiran Motwani
- Department of Medicine, University of Maryland School of Medicine, 22. S. Greene St., Baltimore, MD, 21201-1595, USA.
| | - Jonah Rubin
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Maryland School of Medicine, 22. S. Greene St., Baltimore, MD, 21201-1595, USA
| | - Harris Yfantis
- Department of Pathology, Baltimore VA Medical Center, 10 N Greene St., Baltimore, MD, 21201, USA
| | - Megan Willard
- Section of Digestive Diseases, Department of Medicine, West Virginia University School of Medicine, 1 Stadium Dr., Morgantown, WV, 26506, USA
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8
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Iron Pill-Induced Gastritis in the Paediatric Population. Case Rep Pediatr 2019; 2019:7527608. [PMID: 31612091 PMCID: PMC6755282 DOI: 10.1155/2019/7527608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 08/17/2019] [Indexed: 11/17/2022] Open
Abstract
Iron is the most common trace mineral in the body. The effects of iatrogenic iron pill-induced gastritis (IPIG) at therapeutic levels are underreported and underappreciated in the paediatric population. Herein, we report a case of an 11-year-old boy presenting with increasing epigastric pain and refusing oral intake secondary to iron pill tablets. We report only the second confirmed case of a paediatric patient with IPIG in the peer-reviewed literature.
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9
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Ewing D, Brozovich A, Burns E, Acosta G, Hatcher C, Patel P, Anton R, Abraham B, Samuel L. Gastric Siderosis and Ulceration from Intravenous Iron Supplementation Manifesting as Chronic Upper Gastrointestinal Bleeding: A Case Report and Review of the Literature. Case Rep Gastrointest Med 2019; 2019:1790686. [PMID: 31139476 PMCID: PMC6500599 DOI: 10.1155/2019/1790686] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 04/04/2019] [Indexed: 11/17/2022] Open
Abstract
Iron deficiency is the most common etiology of anemia worldwide and is often managed with varying methods of iron supplementation. Although rare, oral iron supplementation can perpetuate iron deficiency anemia by causing gastric ulceration and upper gastrointestinal bleeding in high-risk populations. However, this complication has not been previously described with intravenous iron supplementation. We present a case of a 63-year-old male with severe iron deficiency anemia on biweekly intravenous iron infusions and weekly packed red blood cell transfusions who presented with melena over several months. Upper endoscopy demonstrated a clean-based gastric body ulcer and nonbleeding gastric varices. Histology of the gastric ulcer was suggestive of iron-induced gastric mucosal injury. This case demonstrates that frequent utilization of intravenous iron and packed red blood cell transfusions may predispose certain patients to the development of iron-induced gastritis and ulceration.
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Affiliation(s)
- Donald Ewing
- Texas A&M University College of Medicine, 8447 Bryan Rd., Bryan, TX 77807, USA
| | - Ava Brozovich
- Texas A&M University College of Medicine, 8447 Bryan Rd., Bryan, TX 77807, USA
| | - Ethan Burns
- Houston Methodist Hospital, Department of Medicine, 6550 Fannin St., Houston, TX 77096, USA
| | - Gonzalo Acosta
- Houston Methodist Hospital, Department of Medicine, 6550 Fannin St., Houston, TX 77096, USA
| | - Courtney Hatcher
- Houston Methodist Hospital, Department of Medicine, 6550 Fannin St., Houston, TX 77096, USA
| | - Pragnesh Patel
- Houston Methodist Hospital, Department of Gastroenterology, 6550 Fannin St., Houston, TX 77096, USA
| | - Rose Anton
- Houston Methodist Hospital, Department of Pathology and Genomic Medicine, 6550 Fannin St., Houston, TX 77030, USA
| | - Bincy Abraham
- Texas A&M University College of Medicine, 8447 Bryan Rd., Bryan, TX 77807, USA
- Houston Methodist Hospital, Department of Gastroenterology, 6550 Fannin St., Houston, TX 77096, USA
| | - Leena Samuel
- Houston Methodist Hospital, Department of Pathology and Genomic Medicine, 6550 Fannin St., Houston, TX 77030, USA
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10
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Morais R, Ribeiro A, Paiva D, Rios E, Rodrigues S, Macedo G. Iron pill-induced gastroduodenopathy. Porto Biomed J 2017; 2:344-346. [PMID: 32258792 DOI: 10.1016/j.pbj.2017.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Accepted: 04/20/2017] [Indexed: 11/19/2022] Open
Affiliation(s)
- Rui Morais
- Gastroenterology Department, Centro Hospitalar de São João, Porto, Portugal
- Porto Medical School, University of Porto, Portugal
| | - Armando Ribeiro
- Gastroenterology Department, Centro Hospitalar de São João, Porto, Portugal
- Porto Medical School, University of Porto, Portugal
| | - David Paiva
- Pathology Department, Centro Hospitalar de São João, Porto, Portugal
- Porto Medical School, University of Porto, Portugal
| | - Elisabete Rios
- Pathology Department, Centro Hospitalar de São João, Porto, Portugal
- Porto Medical School, University of Porto, Portugal
| | - Susana Rodrigues
- Gastroenterology Department, Centro Hospitalar de São João, Porto, Portugal
- Porto Medical School, University of Porto, Portugal
| | - Guilherme Macedo
- Gastroenterology Department, Centro Hospitalar de São João, Porto, Portugal
- Porto Medical School, University of Porto, Portugal
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11
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Meliţ LE, Mărginean CO, Mocanu S, Mărginean MO. A rare case of iron-pill induced gastritis in a female teenager: A case report and a review of the literature. Medicine (Baltimore) 2017; 96:e7550. [PMID: 28746201 PMCID: PMC5627827 DOI: 10.1097/md.0000000000007550] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE The treatment of iron-deficiency anemia with oral iron supplements can present side-effects on the GI tract mucosa including necrosis, ulceration, or ischemia. The particular endoscopic findings and the histopathological exam will establish the diagnosis of erosive gastritis with iron deposits in the gastric mucosa. PATIENT CONCERNS We present the case of a 14-year-old female admitted in our clinic for upper digestive hemorrhage, nausea, melena, and abdominal pain. Her personal history revealed iron deficiency anemia receiving oral iron supplements for approximately 2 weeks. DIAGNOSIS The laboratory tests at the moment of admission pointed out anemia, increased level of serum iron, increased liver transaminases, a decreased level of ferritin, but with normal levels of both total iron-binding capacity and transferrin. INTERVENTIONS The eso-gastro-duodenoscopy revealed multiple brown deposits on the surface of the gastric mucosa and multiple hemorrhagic lesions, under the aspect of erosions all over the gastric mucosa, but more severe in the antral part, and the histopathological exam confirmed the presence of iron deposits at this level. CONCLUSION Iron-pill induced gastritis is a rare, under-diagnosed entity that can be present even at pediatric ages with potential severe clinical impact.
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Affiliation(s)
- Lorena Elena Meliţ
- Department of Pediatrics I, University of Medicine and Pharmacy Department of Pathology, County Hospital, Tîrgu Mureş, Romania
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12
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Sunkara T, Caughey ME, Nigar S, Olivo R, Gaduputi V. Iron Pill Gastritis: An Under Diagnosed Condition With Potentially Serious Outcomes. Gastroenterology Res 2017; 10:138-140. [PMID: 28496538 PMCID: PMC5412550 DOI: 10.14740/gr804w] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/20/2017] [Indexed: 11/20/2022] Open
Abstract
Given the ubiquitous use of oral iron therapy, their side effects are often encountered and well recognized in clinical practice. However, iron pill gastritis remains an often under-reported and elusive diagnosis. An astute clinician should be aware of this condition in order to promptly discontinue oral iron and institute timely treatment. Here in, we present a case of a 46-year-old woman who presented to the gastroenterology clinic with vague epigastric pain and microcytic anemia. Esophagogastroduodenoscopy revealed multiple gastric erosions and non-bleeding gastric antral ulcer with biopsies showing excessive iron deposition suggestive of iron pill gastritis. We reviewed the clinical features, pathology, and treatment of iron pill gastritis along with the review of the literature.
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Affiliation(s)
- Tagore Sunkara
- Department of Gastroenterology and Hepatology, The Brooklyn Hospital Center, Clinical Affiliate of The Mount Sinai Hospital, 121 Dekalb Avenue, Brooklyn, NY 11201, USA
| | - Megan E Caughey
- New York Institute of Technology College of Osteopathic Medicine, Old Westbury, NY, USA
| | - Sofia Nigar
- Department of Gastroenterology and Hepatology, The Brooklyn Hospital Center, Clinical Affiliate of The Mount Sinai Hospital, 121 Dekalb Avenue, Brooklyn, NY 11201, USA
| | - Raquel Olivo
- Department of Gastroenterology and Hepatology, SBH Health System, 4422 Third Avenue, Bronx, NY 10457, USA
| | - Vinaya Gaduputi
- Department of Gastroenterology and Hepatology, SBH Health System, 4422 Third Avenue, Bronx, NY 10457, USA
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13
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Eid R, Arab NTT, Greenwood MT. Iron mediated toxicity and programmed cell death: A review and a re-examination of existing paradigms. BIOCHIMICA ET BIOPHYSICA ACTA-MOLECULAR CELL RESEARCH 2016; 1864:399-430. [PMID: 27939167 DOI: 10.1016/j.bbamcr.2016.12.002] [Citation(s) in RCA: 165] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 11/08/2016] [Accepted: 12/04/2016] [Indexed: 12/11/2022]
Abstract
Iron is an essential micronutrient that is problematic for biological systems since it is toxic as it generates free radicals by interconverting between ferrous (Fe2+) and ferric (Fe3+) forms. Additionally, even though iron is abundant, it is largely insoluble so cells must treat biologically available iron as a valuable commodity. Thus elaborate mechanisms have evolved to absorb, re-cycle and store iron while minimizing toxicity. Focusing on rarely encountered situations, most of the existing literature suggests that iron toxicity is common. A more nuanced examination clearly demonstrates that existing regulatory processes are more than adequate to limit the toxicity of iron even in response to iron overload. Only under pathological or artificially harsh situations of exposure to excess iron does it become problematic. Here we review iron metabolism and its toxicity as well as the literature demonstrating that intracellular iron is not toxic but a stress responsive programmed cell death-inducing second messenger.
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Affiliation(s)
- Rawan Eid
- Department of Chemistry and Chemical Engineering, Royal Military College of Canada, Kingston, Ontario, Canada
| | - Nagla T T Arab
- Department of Chemistry and Chemical Engineering, Royal Military College of Canada, Kingston, Ontario, Canada
| | - Michael T Greenwood
- Department of Chemistry and Chemical Engineering, Royal Military College of Canada, Kingston, Ontario, Canada.
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14
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Antunes AG, Cadillá J, Guerreiro H. Gastric siderosis as a cause of dyspepsia. BMJ Case Rep 2016; 2016:bcr-2016-216862. [PMID: 27511759 DOI: 10.1136/bcr-2016-216862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Artur Gião Antunes
- Gastroenterology Department, Centro Hospitalar do Algarve, Faro, Portugal
| | - Jesus Cadillá
- Pathology Department, Centro Hospitalar do Algarve, Faro, Portugal
| | - Horácio Guerreiro
- Gastroenterology Department, Centro Hospitalar do Algarve, Faro, Portugal
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