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Page 1: Iron Overload

Key Message

“we all have to die of something, but it

shouldn’t be haemochromatosis”

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Page 2: Iron Overload

Haemochromatosis

What is this ‘Haemo’ you may ask?

IRON OVERLOAD

This can be toxic to our body organs.

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Page 3: Iron Overload

What causes it?

fault in an iron control gene inherited from both parents runs in families

too much iron absorbed from food iron overload can cause organ damage and eventually death

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early diagnosis and simple

treatment prevents complications

normal health and life expectancy

is possible

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Who gets it? men and women are equally at risk Caucasian people are at risk 1 in 200 have the fault it runs in families so family members at risk

frequent and heavy alcohol drinkers taking iron supplements eating large amounts of iron-rich foods taking high doses of vitamin C men & post-menopausal women at greatest risk (people who donate blood are at lower risk)

untreated haemochromatosis frequent and heavy alcohol drinkers

genetic fault

excess iron

iron overload

organ damage

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Who gets it?

relatives of people with haemochromatosis are at risk relatives need to be tested

– brothers and sisters– mother and father– children over 18 years– grandparents– aunts, uncles– nieces, nephews– half-siblings

unrelated people

1 in 200 risk

children

1 in 20 risk

brothers & sisters

1 in 4 risk

cousins are more distant so routine testing isn’t strongly recommended5

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How is it managed?

simple blood tests, arranged by a doctor, can detect– iron overload– the genetic faults

simple treatment removes excess iron– giving blood, just like a blood donation at a blood bank– this is called ‘venesection’– 500mL blood = 1 venesection = 0.25 grams iron

simple advice on diet helps to prevent extra iron absorption haemochromatosis can’t be treated by diet alone

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Early symptoms

harder to diagnose early…..

fatigue, weakness,

lethargy, apathy,

weight loss, joint aches

abdominal pains…..

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Late symptoms

classical description was “bronze diabetes” easier to diagnose late…..

1st & 2nd finger knuckle arthritis

liver failure and pigmented skin

the “iron salute”

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Organ damage

LIVER liver damage, cirrhosis, liver failure, liver cancer, sometimes requiring liver transplantsymptoms of fatigue, liver pain, enlarged liver, weakness, weight loss, abnormal blood tests for liver function, jaundice (yellowness of skin and whites of eyes)

HEART arrhythmias, cardiomyopathy, heart failure symptoms of fatigue, palpitations, shortness of breath, breathlessness with exertion, ankle swelling

PANCREAS iron in the pancreas can cause diabetessymptoms of high blood sugar include fatigue, thirst, hunger, increase in urinary frequency, slow-to-heal skin infections, dizziness

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Organ damage

JOINTS 

most commonly affected joints are the hands, wrists, shoulders, hips, knees and ankles arthritis can lead to joint replacement surgery at a young agea classic finding is of swelling in the 1st and 2nd finger knuckles and the “iron salute”

SKIN iron overload may cause slate grey or bronze discolouration of the skin, loss of body hair

SEX ORGANS

men: low testosterone, impotence (erection problems), loss of libido, shrinking testicles (which doctors call testicular atrophy), development of ‘man boobs’ (which doctors call gynaecomastia)

women: irregular or no periods, early menopause, loss of libido

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What tests are needed?

iron studies tell

you about your

current iron

overload

gene test tells you

about your future

risk of iron

overload and if

your family needs

to be tested

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Treatment

venesection / phlebotomy treatment removes excess iron– Like a blood donation

1. iron unloading phase – frequent venesections

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2. life-long maintenance phase– monitoring iron levels at least every 12

months, usually every 3-6 months– enough venesections every year to keep

SF at a safe level (highly individual)

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Key Message

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“we all have to die of something, but it

shouldn’t be haemochromatosis”

Page 14: Iron Overload

Tapirs can get it too!

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