What does this research mean for the field?

Parenteral iron overdose is a heterogeneous clinical syndrome distinct from oral iron poisoning, where conventional laboratory markers like serum iron concentration do not reliably predict toxicity and oral iron management thresholds may not apply. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.CHALLENGES_CONSENSUS.

What question did this study set out to answer?

To map existing evidence on parenteral iron overdose and summarize exposure patterns, clinical presentations, laboratory profiles, therapeutic interventions, and clinical outcomes.

September 10, 2026Clinical Toxicology

Parenteral iron overdose: a scoping review

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Authors

HCHung-Hsiang ChenChina Medical University SWShih-Hao WuChina Medical University HMHan-Wei MuChina Medical University

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Implication

Scoping review reveals serum iron concentrations do not reliably predict toxicity in parenteral iron overdose, indicating clinical presentation should guide treatment rather than traditional cutoffs.

Key Points

To map existing evidence on parenteral iron overdose and summarize exposure patterns, clinical presentations, laboratory profiles, therapeutic interventions, and clinical outcomes.
Searched Embase, Ovid MEDLINE, and Cochrane CENTRAL through December 31, 2025, using the Arksey and O'Malley scoping review framework.
Two reviewers independently screened records and extracted clinical data from human reports of acute parenteral iron overdose or supratherapeutic repeated administration, resolving discrepancies with a third reviewer.
Across 17 reports encompassing 49 patients, exposures comprised acute single-dose overdoses (41.4%, 12/29 classifiable cases) and subacute cumulative exposures (58.6%, 17/29), with an overall survival rate of 98.0% (48/49).
Serum iron concentrations failed to correlate with clinical severity: patients with levels exceeding 2,000 µg/dL remained asymptomatic, whereas a patient with ~112 µg/dL suffered shock, disseminated intravascular coagulation, and multiorgan failure.
Liver toxicity developed in 82.4% of subacute cases but 0% of acute cases, and chelation patterns varied markedly, with four acute overdose patients recovering without chelation despite serum iron concentrations of 1,301–1,830 µg/dL.

Cite This Study

Chen et al. (2026) studied this question.

synapsesocial.com/papers/6aa27aca58559d80afc738dd https://doi.org/10.1080/15563650.2026.2727916

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Implication

Scoping review reveals serum iron concentrations do not reliably predict toxicity in parenteral iron overdose, indicating clinical presentation should guide treatment rather than traditional cutoffs.

Parenteral iron overdose: a scoping review

Discussion

Member takes

Implication

Key Points

Cite This Study

Parenteral iron overdose: a scoping review

Discussion

Member takes

Implication

Key Points

Cite This Study

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