The possible sarcoma-inducing potential of intramuscular iron was fully discussed 15 years ago (SED-9, 375) (33) and no new information on the topic has come to light. The conclusion at that time was that the evidance linking intramuscular iron to sarcomatous change was scanty.
Saccharated ferric oxide, an intravenous formulation of iron that is used when oral iron is not effective in anemia, can cause osteomalacia during long-term use. The underlying mechanism of nephropathy leading to bone toxicity has recently been reviewed (34).
Although total dose infusions of iron (see the section on Intravenous iron under Immunologic) can cause rheumatoid arthritis to flare up, this has not been demonstrated with oral iron. However, a patient who has reacted in this way to an infusion can subsequently relapse if given oral iron.
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