From the Guidelines
Yes, iron infusions can cause bruising at the injection site, which is a common side effect that occurs when the needle used for the infusion damages small blood vessels under the skin, allowing blood to leak into surrounding tissues. This is supported by the expert consensus guidelines on intravenous iron uses, formulations, administration, and management of reactions 1. The bruising typically appears as a blue, purple, or yellow discoloration and may be accompanied by tenderness or swelling. Most bruising from iron infusions is mild and resolves within a few days to a week without specific treatment.
To minimize bruising, healthcare providers often apply pressure to the injection site after removing the needle and may recommend avoiding blood thinners before the procedure if medically appropriate, as suggested by the guidelines on management of iron deficiency anemia 1. Patients can reduce discomfort by applying cold compresses to the area for the first 24 hours after the infusion, followed by warm compresses to help the body reabsorb the leaked blood more quickly. If bruising is severe, spreads, or is accompanied by significant pain or signs of infection, patients should contact their healthcare provider promptly. It's also important to note that true anaphylaxis is very rare, and most reactions to intravenous iron are complement activation–related pseudo-allergy (infusion reactions) and should be treated as such 1.
Some key points to consider when administering iron infusions include:
- Using formulations that can replace iron deficits with 1 to 2 infusions, such as low molecular weight iron dextran (LMWID), ferumoxytol, ferric carboxymaltose (FCM), and ferric derisomaltose (FDI) 1
- Monitoring for infusion reactions and treating them promptly if they occur 1
- Avoiding the use of oral iron if it is not likely to be effective due to impaired absorption or other factors 1
- Considering the use of intravenous iron in situations where oral iron is not effective or not tolerated 1
From the Research
Iron Infusion and Bruising
- The provided studies do not directly address the question of whether iron infusion can cause bruising 2, 3, 4, 5, 6.
- However, the studies discuss the safety and adverse event profiles of different intravenous iron formulations, including iron sucrose, iron dextran, ferric carboxymaltose, and ferumoxytol 2, 3, 5, 6.
- Common adverse events associated with intravenous iron infusions include non-anaphylactoid reactions, such as non-life-threatening hypotension, nausea, and exanthema 2, as well as infusion reactions, which can range from mild to severe 3, 4, 5.
- While bruising is not specifically mentioned as an adverse event in the provided studies, it is possible that it could occur as a result of the infusion process or as a side effect of the iron formulation itself.
- Further research would be needed to determine the relationship between iron infusion and bruising 2, 3, 4, 5, 6.