Initial symptoms of iron poisoning?

summary

Iron poisoning generally refers to hemochromatosis. Hemochromatosis (HC), also known as hereditary hemochromatosis (HHC, Hh), is a common chronic iron overload disease and an autosomal recessive genetic disease; Due to the improper increase of intestinal iron absorption, excessive iron is stored in the liver, heart, pancreas and other parenchymal cells, leading to tissue and organ degeneration and diffuse fibrosis, metabolic and functional disorders. Initial symptoms of iron poisoning? Let's talk about it.

Initial symptoms of iron poisoning?

1. Skin pigmentation 90% ～ 100% of patients have skin pigmentation. The characteristic metallic color or slate grey is sometimes described as bronze or dark brown due to increased melanin (which leads to bronze) and iron deposition (which leads to grey pigment) in the dermis. The skin is dry, the surface is smooth and thin, the elasticity is poor, and the hair is sparse. Pigmentation is usually systemic, but it may be more obvious in the exposed skin, armpit, vulva, nipple and scar. Oral mucosa and gingiva also have pigmentation. The distribution of pigmentation is similar to that of chronic adrenocortical insufficiency.

2. Secondary diabetes occurs in 50% - 80% of patients, and is more likely to occur in patients with family history of diabetes. The patients with mild damage in the early stage may have no typical symptoms, while those with severe damage in the middle and late stage may have typical symptoms. Late complications are the same as diabetes caused by other causes. Patients without timely treatment may have complications of acute metabolic disorder, such as ketoacidosis, nonketotic hyperosmolar diabetic coma, etc. In the past, it was thought that the destruction of islet B cells was the main cause of diabetes, but in recent years, it was found that the blood insulin concentration of some patients did not decrease significantly. Therefore, some people think that iron has a direct antagonistic effect on insulin, which can reduce the utilization of glucose in peripheral tissues, resulting in the increase of blood glucose and diabetes. Treatment is similar to other types of diabetes, but HC patients are more often associated with significant insulin resistance.

3. Liver lesion is the most common clinical manifestation of HHC. Hepatomegaly can occur before symptoms or abnormal liver function. More than 90% of patients with symptoms can have hepatomegaly, and some of them have little laboratory evidence of liver function damage. Mild elevation of transaminase was found in 30% ～ 50% of patients. After bloodletting therapy, transaminase returned to normal. Portal hypertension and esophageal varices are less common than cirrhosis caused by other reasons. 14% (10% - 30%) of HHC patients with long-term liver cirrhosis had canceration, which was higher than that of any type of liver cirrhosis; Most tumors are multifocal and may have metastasized when symptoms appear. Splenomegaly occurs in about half of symptomatic patients.

matters needing attention

1. Rational use of iron supplements. Disulfide propanol is forbidden in the application of iron preparation. There are two active sulfhydryl groups in the molecule of this product, which have high affinity with metal. It can capture the metal that has been combined with the enzyme system in the tissue, form non-toxic compounds that are not easy to decompose, and excrete them from the urine to restore the activity of the enzyme system, so it has detoxification effect. In the treatment of metal poisoning, we must repeatedly give sufficient amount of this product, so that the free metal is combined with dimercaptopropanol until discharged. The first antidote is arsenic, mercury, lock and antimony poisoning. 2. Disulfide propanol is forbidden in the application of iron preparation. 3. Dust prevention measures should be taken in the production place, publicity and education should be strengthened, and dust sources should be sealed.