Keracunan zat besi: Perbedaan antara revisi

{{Infobox medical condition|name=|synonym=Iron toxicity|image=Dr Williams' 'Pink Pills', London, England, 1850-1920 Wellcome L0058211 (cropped).jpg|image_size=|alt=|caption=Iron supplement from the late 19th and early 20th century|pronounce=|specialty=[[Emergency medicine]]|symptoms='''Initial''': [[Vomiting]], [[diarrhea]], [[abdominal pain]], drowsiness<ref name=Mer2023>{{cite web |title=Iron Poisoning - Injuries and Poisoning |url=https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning |website=Merck Manuals Consumer Version |accessdate=27 November 2023 |archive-date=23 November 2023 |archive-url=https://web.archive.org/web/20231123020506/https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning |url-status=live }}</ref> '''Later''': Liver problems, fever, bleeding, [[metabolic acidosis]]<ref name=Mer2023>{{cite web |title=Iron Poisoning - Injuries and Poisoning |url=https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning |website=Merck Manuals Consumer Version |accessdate=27 November 2023 |archive-date=23 November 2023 |archive-url=https://web.archive.org/web/20231123020506/https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning |url-status=live }}</ref>|onset=Within 6 hrs<ref name=Man2005>{{Cite journal|last1=Manoguerra|first1=Anthony S.|last2=Erdman|first2=Andrew R.|last3=Booze|first3=Lisa L.|last4=Christianson|first4=Gwenn|last5=Wax|first5=Paul M.|last6=Scharman|first6=Elizabeth J.|last7=Woolf|first7=Alan D.|last8=Chyka|first8=Peter A.|last9=Keyes|first9=Daniel C.|last10=Olson|first10=Kent R.|last11=Caravati|first11=E. Martin|date=2005-01-01|title=Iron Ingestion: an Evidence-Based Consensus Guideline for Out-of-Hospital Management|journal=Clinical Toxicology|volume=43|issue=6|pages=553–570|doi=10.1081/CLT-200068842|pmid=16255338|issn=1556-3650|doi-access=free}}</ref>|duration=|causes=>20 mg/kg elemental iron (>60 mg/kg severe)<ref name=Mer2023Pro>{{cite web |title=Iron Poisoning - Injuries; Poisoning |url=https://www.merckmanuals.com/professional/injuries-poisoning/poisoning/iron-poisoning?query=Iron%20Poisoning |website=Merck Manuals Professional Edition |accessdate=27 November 2023 |archive-date=28 November 2023 |archive-url=https://web.archive.org/web/20231128033805/https://www.merckmanuals.com/professional/injuries-poisoning/poisoning/lead-poisoning |url-status=live }}</ref>|risks=|diagnosis=Based on symptoms, history of events, [[blood iron levels]]<ref name=Mer2023>{{cite web |title=Iron Poisoning - Injuries and Poisoning |url=https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning |website=Merck Manuals Consumer Version |accessdate=27 November 2023 |archive-date=23 November 2023 |archive-url=https://web.archive.org/web/20231123020506/https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning |url-status=live }}</ref><ref name=Stat2023>{{Citation|last1=Yuen|first1=Ho-Wang|title=Iron Toxicity|date=2020|url=http://www.ncbi.nlm.nih.gov/books/NBK459224/|work=StatPearls|place=Treasure Island (FL)|publisher=StatPearls Publishing|pmid=29083637|access-date=2020-12-30|last2=Becker|first2=Wenxia|archive-date=2022-05-17|archive-url=https://web.archive.org/web/20220517224030/https://www.ncbi.nlm.nih.gov/books/NBK459224/|url-status=live}}</ref>|differential=|prevention=|treatment=[[Whole bowel irrigation]], [[deferoxamine]], [[hemodialysis]]<ref name=Mer2023>{{cite web |title=Iron Poisoning - Injuries and Poisoning |url=https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning |website=Merck Manuals Consumer Version |accessdate=27 November 2023 |archive-date=23 November 2023 |archive-url=https://web.archive.org/web/20231123020506/https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning |url-status=live }}</ref><ref name=Stat2023>{{Citation|last1=Yuen|first1=Ho-Wang|title=Iron Toxicity|date=2020|url=http://www.ncbi.nlm.nih.gov/books/NBK459224/|work=StatPearls|place=Treasure Island (FL)|publisher=StatPearls Publishing|pmid=29083637|access-date=2020-12-30|last2=Becker|first2=Wenxia|archive-date=2022-05-17|archive-url=https://web.archive.org/web/20220517224030/https://www.ncbi.nlm.nih.gov/books/NBK459224/|url-status=live}}</ref>|medication=|prognosis=|frequency=Relatively common<ref name=Mer2023>{{cite web |title=Iron Poisoning - Injuries and Poisoning |url=https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning |website=Merck Manuals Consumer Version |accessdate=27 November 2023 |archive-date=23 November 2023 |archive-url=https://web.archive.org/web/20231123020506/https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning |url-status=live }}</ref>|deaths=}}'''Keracunan zat besi''' merupakan kondisi yang diakibatkan kelebihan suplemen [[zat besi]] kemudian menyebabkan [[toksisitas akut]] . Gejala yang muncul keracunan zat besi dalam kurung waktu 6 jam pertama seperti: mengantuk, [[muntah]], [[Mulas|sakit perut]], dan [[diare]] . <ref name="Mer2023">{{Citecite web |title=Iron Poisoning - Injuries and Poisoning |url=https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning |website=Merck Manuals Consumer Version |accessdate=27 November 2023 |archive-date=23 November 2023 |archive-url=https://web.archive.org/web/20231123020506/https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning |url-status=live |access-date=27 November 2023}}</ref> Untuk kondisi yang parah bisa menimbulkan [[takipnea]], [[tekanan darah rendah]], [[sawan]], atau [[Koma (medis)|koma]] . <ref name="Mer2023">{{cite web |title=Iron Poisoning - Injuries and Poisoning |url=https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning |website=Merck Manuals Consumer Version |accessdate=27 November 2023 |archive-date=23 November 2023 |archive-url=https://web.archive.org/web/20231123020506/https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning |url-status=live }}</ref> Hal yang sering terjadi kondisi membaik walau sebentar, kemudian muncul gejala [[asidosis metabolik]] , demam, pendarahan, dan kemudian muncul masalah di organ hati bisa terjadi. <ref name="Mer2023">{{cite web |title=Iron Poisoning - Injuries and Poisoning |url=https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning |website=Merck Manuals Consumer Version |accessdate=27 November 2023 |archive-date=23 November 2023 |archive-url=https://web.archive.org/web/20231123020506/https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning |url-status=live }}</ref> Pada kondisi inilah potensi orang keracunan zat besi bisa meninggal dunia dan jika sembuh, kondisi seperti [[Sirosis|sirosis hati]] bisa terjadi. <ref name="Mer2023">{{cite web |title=Iron Poisoning - Injuries and Poisoning |url=https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning |website=Merck Manuals Consumer Version |accessdate=27 November 2023 |archive-date=23 November 2023 |archive-url=https://web.archive.org/web/20231123020506/https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning |url-status=live }}</ref>

Suplemen zat besi bisa didapatkan [[Penggolongan Obat|tanpa resep]] dalam bentuk [[Garam dapur|garam]] besi tunggal atau sediaan dalam kombinasi dengan suplemen [[vitamin]] seperti vitamin prenatal . <ref name="Stat2023">{{Citation|last1=Yuen|first1=Ho-Wang|title=Iron Toxicity|date=2020|url=http://www.ncbi.nlm.nih.gov/books/NBK459224/|work=StatPearls|place=Treasure Island (FL)|publisher=StatPearls Publishing|pmid=29083637|access-date=2020-12-30|last2=Becker|first2=Wenxia|last=Yuen|first=Hoarchive-Wang|journal=StatPearls|archivedatedate=2022-05-17|archiveurlarchive-url=https://web.archive.org/web/20220517224030/https://www.ncbi.nlm.nih.gov/books/NBK459224/|url-status=live}}</ref> Kejadian seperti [[overdosis]] bisa terjadi tanpa disengaja, terutama pada anak kecil, atau juga disengaja, seperti upaya [[bunuh diri]] pada orang yang lebih dewasa. <ref name="Stat2023">{{Citation|last1=Yuen|first1=Ho-Wang|title=Iron Toxicity|date=2020|url=http://www.ncbi.nlm.nih.gov/books/NBK459224/|work=StatPearls|place=Treasure Island (FL)|publisher=StatPearls Publishing|pmid=29083637|access-date=2020-12-30|last2=Becker|first2=Wenxia|archive-date=2022-05-17|archive-url=https://web.archive.org/web/20220517224030/https://www.ncbi.nlm.nih.gov/books/NBK459224/|url-status=live}}</ref> Diagnosisnya berdasarkan pada gejala, riwayat kejadian, dan kadar zat besi dalam darah . <ref name="Mer2023">{{Cite web|title=Iron Poisoning - Injuries and Poisoning |url=https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning |website=Merck Manuals Consumer Version |archive-date=23 November 2023 |archive-url=https://web.archive.org/web/20231123020506/https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning |url-status=live |access-date=27 November 2023}}<cite class="citation web cs1" data-ve-ignore="true">[https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning "Iron Poisoning - Injuries and Poisoning"]. ''Merck Manuals Consumer Version''. [https://web.archive.org/web/20231123020506/https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning Archived] from the original on 23 November 2023<span class="reference-accessdate">. Retrieved <span class="nowrap">27 November</span> 2023</span>.</cite></ref> <ref name="Stat2023">{{Citation|last1=Yuen|first1=Ho-Wang|title=Iron Toxicity|date=2020|url=http://www.ncbi.nlm.nih.gov/books/NBK459224/|work=StatPearls|place=Treasure Island (FL)|publisher=StatPearls Publishing|pmid=29083637|access-date=2020-12-30|last2=Becker|first2=Wenxia|archive-date=2022-05-17|archive-url=https://web.archive.org/web/20220517224030/https://www.ncbi.nlm.nih.gov/books/NBK459224/|url-status=live}}</ref> Terkadang pemeriksaan menggunakan [[sinar-X]] bisa digunakan untuk melihat pil-pil di usus. <ref name="Mer2023">{{cite web |title=Iron Poisoning - Injuries and Poisoning |url=https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning |website=Merck Manuals Consumer Version |accessdate=27 November 2023 |archive-date=23 November 2023 |archive-url=https://web.archive.org/web/20231123020506/https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning |url-status=live }}</ref>

Tindakan awal untuk terapi pada kondisi tersebut mungkin melakukan metode irigasi seluruh usus . <ref name="Mer2023">{{Cite web|title=Iron Poisoning - Injuries and Poisoning |url=https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning |website=Merck Manuals Consumer Version |archive-date=23 November 2023 |archive-url=https://web.archive.org/web/20231123020506/https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning |url-status=live |access-date=27 November 2023}}<cite class="citation web cs1" data-ve-ignore="true">[https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning "Iron Poisoning - Injuries and Poisoning"]. ''Merck Manuals Consumer Version''. [https://web.archive.org/web/20231123020506/https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning Archived] from the original on 23 November 2023<span class="reference-accessdate">. Retrieved <span class="nowrap">27 November</span> 2023</span>.</cite></ref> Untuk yang mengalami gejala parah atau jumlah kadar zat besinya tinggi, diperlukan pengobatan menggunakan sediaan obat dengan kandungan [[Deferoksamin|deferoxamine]] yang bisa diberikan di rumah sakit. <ref name="Mer2023">{{cite web |title=Iron Poisoning - Injuries and Poisoning |url=https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning |website=Merck Manuals Consumer Version |accessdate=27 November 2023 |archive-date=23 November 2023 |archive-url=https://web.archive.org/web/20231123020506/https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning |url-status=live }}</ref> Tindakan seperti[[hemodialisis]] atau pembedahan mungkin bisa menjadi pilihan lainnya. <ref name="Stat2023">{{Citation|title=Iron Toxicity|date=2020|url=http://www.ncbi.nlm.nih.gov/books/NBK459224/|place=Treasure Island (FL)|publisher=StatPearls Publishing|pmid=29083637|access-date=2020-12-30|last2=Becker|first2=Wenxia|last=Yuen|first=Ho-Wang|journal=StatPearls|archivedate=2022-05-17|archiveurl=https://web.archive.org/web/20220517224030/https://www.ncbi.nlm.nih.gov/books/NBK459224/}}<cite class="citation cs2" data-ve-ignore="true" id="CITEREFYuenBecker2020">Yuen, Ho-Wang; Becker, Wenxia (2020), [http://www.ncbi.nlm.nih.gov/books/NBK459224/ "Iron Toxicity"], ''StatPearls'', Treasure Island (FL): StatPearls Publishing, [[PMID (identifier)|PMID]]&nbsp;[https://pubmed.ncbi.nlm.nih.gov/29083637 29083637], [https://web.archive.org/web/20220517224030/https://www.ncbi.nlm.nih.gov/books/NBK459224/ archived] from the original on 2022-05-17<span class="reference-accessdate">, retrieved <span class="nowrap">2020-12-30</span></span></cite></ref> Jika tidak ada gejala yang muncul dalam kurung waktu kurang dari 6 jam setelah pemberian, biasanya tidak diperlukan pengobatan secara khusus. <ref name="Man2005">{{Cite journal|last1=Manoguerra|first1=Anthony S.|last2=Erdman|first2=Andrew R.|last3=Booze|first3=Lisa L.|last4=Christianson|first4=Gwenn|last5=Wax|first5=Paul M.|last6=Scharman|first6=Elizabeth J.|last7=Woolf|first7=Alan D.|last8=Chyka|first8=Peter A.|last9=Keyes|first9=Daniel C.|last10=Olson|first10=Kent R.|last11=Caravati|first11=E. Martin|date=2005-01-01|title=Iron Ingestion: an Evidence-Based Consensus Guideline for Out-of-Hospital Management|journal=Clinical Toxicology|volume=43|issue=6|pages=553–570|doi=10.1081/CLT-200068842|pmid=16255338|issn=1556-3650|lastdoi-access=Manoguerra|first=Anthony S.free}}</ref>

Keracunan zat besi cukup umum terjadi. <ref name="Mer2023">{{Cite web|title=Iron Poisoning - Injuries and Poisoning |url=https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning |website=Merck Manuals Consumer Version |archive-date=23 November 2023 |archive-url=https://web.archive.org/web/20231123020506/https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning |url-status=live |access-date=27 November 2023}}<cite class="citation web cs1" data-ve-ignore="true">[https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning "Iron Poisoning - Injuries and Poisoning"]. ''Merck Manuals Consumer Version''. [https://web.archive.org/web/20231123020506/https://www.merckmanuals.com/home/injuries-and-poisoning/poisoning/iron-poisoning Archived] from the original on 23 November 2023<span class="reference-accessdate">. Retrieved <span class="nowrap">27 November</span> 2023</span>.</cite></ref> Sebagai tanggapan, kejadian keracunan zat beri di tahun 1997 [[Badan Pengawas Obat dan Makanan Amerika Serikat|Badan Pengawas Obat dan Makanan AS (FDA)]] mulai menerapkan peraturan yang dimana produk suplemen zat besi diwajibkan memasang label peringatan untuk kemasan zat besi dengan dosis satuan yang mengandung lebih dari 30 mg unsur besi per dosis. <ref>{{Cite journal|last=Tenenbein|first=Milton|date=1 June 2005|title=Unit-Dose Packaging of Iron Supplements and Reduction of Iron Poisoning in Young Children|url=https://jamanetwork.com/journals/jamapediatrics/fullarticle/486039|journal=Archives of Pediatrics & Adolescent Medicine|volume=159|issue=6|pages=557–560|doi=10.1001/archpedi.159.6.557|issn=1072-4710|archive-url=https://web.archive.org/web/20120208025434/http://archpedi.ama-assn.org/cgi/content/full/159/6/557|archive-date=8 February 2012|access-date=28 November 2023|url-status=live}}</ref>