A 3 years old boy presented with h/o fever, gross hematuria and vomiting after ingesting some locally popular ayurvedic drug formulation called GERU which contains Ferric oxide. On investigations he was found to be G6PD deficient which lead to Intravascular hemolysis and Methemoglobinemia. He was aggressively and conservatively managed in a Paediatrics ICU and was discharged in stable condition after 5 days.

Keywords: G6PD Deficiency; Intravascular Hemolysis; Hemoglobinuria; Methemoglobinemia; Geru; Hematite; Toxicity; Ayurvedic Medication; Ferric Oxide; Hypoxia; Forced Alkaline Diuresis; Saturation Gap; Methylene Blue.