What is the role of lab testing in the diagnosis of iron toxicity?

Updated: Feb 04, 2019
  • Author: Clifford S Spanierman, MD; Chief Editor: Michael A Miller, MD  more...
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Glucose levels exceeding 150 mg/dL are common with severe iron toxicity. Following glucose levels is important because hepatic dysfunction may cause hypoglycemia.

On the CBC, a white blood cell (WBC) count of more than 15,000/mm3 is associated with severe iron poisoning. A CBC is also helpful because anemia from blood loss may develop.

LFTs are indicated because hepatic dysfunction is common in severe iron poisoning. The liver is the first organ outside of the GI tract to receive a large iron load, which enters through the portal blood supply.

Electrolyte measurements and renal function tests assist in calculation of the anion gap (see the Anion Gap calculator) and detection of electrolyte abnormalities and the presence of prerenal azotemia. Iron toxicity is one of the causes of acidosis with an increased anion gap, as noted in the mnemonic MUDPILES (M-methanol; U-uremia; D-diabetic ketoacidosis, alcoholic ketoacidosis; P-paraldehyde, phenformin; I-iron, isoniazid; L-lactic [ie, carbon monoxide, cyanide]; E-ethylene glycol; S-salicylates).

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