Sir.—We read with interest the article by Geffer and Opas, "Phosphate Poisoning Complicating Treatment for Iron Ingestion" (Journal 1980;134: 509-510). The authors reported that treatment of the patient began only after he had passed a bloody stool. We believe that on admission, gastric lavage with a solution of desferrioxamine (2 g/L of warm water) should have been performed. After lavage, 2 to 10 g of desferrioxamine dissolved in 50 mL of water should be left in the stomach.1 If the patient is symptomatic (ie, bloody stool) or if blood levels of iron are above 350 μg/dL, parenteral desferrioxamine is the drug of choice.2
Five cases of iron poisoning treated in our hospital according to this protocol all showed uneventful recovery, as well as lack of side effects from desferrioxamine administration.