What is the diagnosis for a patient who experiences vomiting shortly after administration of iron supplements (ferrous sulfate)?

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Differential Diagnosis for Vomiting after Iron Drops Administration

  • Single most likely diagnosis
    • Gastrointestinal irritation or side effect of iron supplementation: This is the most likely diagnosis as iron supplements are known to cause gastrointestinal side effects, including nausea and vomiting, especially when taken on an empty stomach or in high doses.
  • Other Likely diagnoses
    • Gastroesophageal reflux disease (GERD): The administration of iron drops could exacerbate existing GERD, leading to vomiting.
    • Infection or gastroenteritis: If the patient has an underlying infection, the introduction of iron drops could trigger vomiting.
    • Allergic reaction to the iron formulation: Although less common, an allergic reaction to the ingredients in the iron drops could cause vomiting.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Intussusception (in pediatric patients): While rare, if the vomiting is accompanied by other symptoms like abdominal pain, bloody stools, or a palpable abdominal mass, intussusception should be considered, especially in pediatric patients.
    • Hemorrhagic disease of the newborn (if the patient is a newborn): Although iron drops are not typically associated with this condition, any sign of bleeding or vomiting in a newborn should prompt an investigation into hemorrhagic disease of the newborn, which can be life-threatening.
  • Rare diagnoses
    • Eosinophilic esophagitis: This condition could be triggered or exacerbated by the introduction of iron drops, especially if the patient has a history of atopic diseases or food allergies.
    • Iron overdose: Although the context suggests therapeutic administration, accidental or intentional overdose of iron can lead to severe vomiting among other symptoms, and is a medical emergency.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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