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Iron stain following an intravenous iron infusion

Martin L Canning and Kenneth A Gilmore
Med J Aust 2017; 207 (2): . || doi: 10.5694/mja17.00040
Published online: 17 July 2017

Iron polymaltose was administered via rapid infusion to a patient with iron deficiency anaemia. During administration, we observed staining and ceased the infusion (Figure, A; 30 minutes after cessation). Staining extended to a large part of the arm, and follow-up at 21 days revealed no change in size (Figure, B). Persistent discolouration of the skin is a risk associated with intramuscular and intravenous iron administration.1,2 It has been reported with multiple iron preparations,3-5 and one study found an incidence of 1.3%.5 Iron staining has been successfully treated with laser therapy, resulting in almost complete disappearance.3 Intravenous infusion sites should be monitored closely for swelling before and during administration to minimise the risk of extravasation causing staining.


  • Prince Charles Hospital, Brisbane, QLD



Competing interests:

No relevant disclosures.

  • 1. Australian Medicines Handbook [online]. Adelaide: Australian Medicines Handbook, 2017. https://amhonline.amh.net.au (accessed Mar 2017).
  • 2. Low MSY, Grigoriadis G. Iron deficiency and new insights into therapy. Med J Aust 2017; 207: 81-87.
  • 3. Hammami Ghorbel H, Lacour JP, Passeron T. Successful treatment with 532-nm Q-switched Nd:YAG laser of cutaneous siderosis following intravenous iron extravasation. J Eur Acad Dermatol Venereol 2015; 29: 818-819.
  • 4. Zuckerman MD, Greenston M. Extraordinary extravasation. N Z Med J 2014; 127: 100-101.
  • 5. Anker SD, Colet JC, Filippatos G, et al. Ferric carboxymaltose in patients with heart failure and iron deficiency. N Engl J Med 2009; 361: 2436-2448.

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