Adverse Effects of Intramuscular Iron Injection

I. Amitai, MD, M. Acker, MD, Pediatric Department, Hadassah University Hospital, Mount Scopous, P.O. Box 24035, Jerusalem 91240 (Israel) Iron dextran preparations have long been blamed for causing systemic and local side effects. Allergic purpura was reported following intravenous administration of iron dextran [1]. The local side effects consist of pain, inflammation and brownish discolorations at the injection site [2]. We report here a child who had allergic purpura and another with lipomyodystrophy at the injection site, following intramuscular iron dextran injection. Case 1: A 21-month-old infant was admitted because of edema of the eyelids and a hemorrhagic rash of the lower limbs. A week before his admission iron deficiency was found and he was treated by intramuscular injections of iron dextran (Impheron®). Several hours after the third injection of 100 mg of iron dextran, fever, edema of the eyelids and a red rash on the legs occurred. The rash consisted of discrete purpuric lesions in a symmetric distribution at the posterior aspect of Fig. 1. Case 2: the dimple on the left buttock following injection of iron dextran preparation. 342 Amitai/Acker