iron overload

Question 1

what are the two types?

Answer 1

hereditary haemochromatosis
secondary iron overload

Question 2

what causes hereditary haemochromatosis?

Answer 2

mutations in HFE leading to decreased synthesis if hepcidin which causes accumulation of iron

Question 3

how do patients with HH present?

Answer 3

middle aged or later
weakness/fatigue
arthritis
cirrhosis
diabetes
cardiomyopathy
iron >5g

Question 4

what shows diagnosis of HH?

Answer 4

transferrin sat >50%
inc. iron stores (serum ferritin)
assess for cirrhosis

Question 5

what is the management for HH?

Answer 5

insulin + weekly venesection
aim to exhaust iron store then maintain

Question 6

what are the risks for patients with HH?

Answer 6

hepatocellular carcinoma
presents often when end organ damage has occurred

Question 7

what is the cause of secondary iron overload?

Answer 7

repeated red cell transfusions

Question 8

what is the main issue with secondary iron overload?

Answer 8

only presents when damage is already done