Scenario 2 IV Iron Anaphylaxis Disclosure-Patient
1 week ago: You have a PMHx of CKD4 2/2 poorly controlled DM2, HFrEF 2/2 ischemia, CAD and anemia and presented to your renal clinic today for routine follow up. You have been a patient of renal clinic for the past 2 years and they tell you that your kidney function continues to worsen. It’s not entirely clear to you, but they say because your kidneys are sick you cannot pee out extra fluid which makes it build up in your lungs. You do know that you have been admitted to the hospital 3 times already this year for heart failure exacerbations. During your visit today, your kidney doctor tells you that you need a fistula created to start dialysis in the near future. You ask a lot of questions about dialysis and fistulas because it’s pretty overwhelming. At the end of your visit your doctor tells you that you are also anemic and would benefit from getting IV iron to bring up your blood counts. They say that they can do this via an IV instead of making you take more pills, which sounds great to you. The nurse makes you an appointment for that Friday afternoon.
Today: You woke up yesterday in an ICU feeling like you had been run over by a truck. The last thing you can remember is you were at infusion clinic getting this IV iron your doctor had prescribed for some reason or another. Then next thing you know you wake up in intensive care connected to tubes everywhere. Your wife comes in and is crying hysterically telling you that you died and they brought you back to life. You certainly feel like you died given how your ribs feel. Ouch. Your wife starts tells you that the doctors think you had an allergic reaction to the IV iron they were giving you. She asks you why you were getting IV iron and if you knew it could kill you. You don’t remember anything about IV iron, why you were getting it, or what the risks were of it. You do remember that your kidney doctor is the one who said you needed it.