Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access
Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc
Journal website http://www.gastrores.org

Review

Volume 12, Number 5, October 2019, pages 221-232

Diagnosis and Treatment of Genetic HFE-Hemochromatosis: The Danish Aspect

Figures

Figure 1.
Figure 1. Diagnostic and therapeutic algorithm (simplified) in the assessment of HFE-hemochromatosis.
Figure 2.
Figure 2. A 55-year-old woman with hemochromatosis and liver fibrosis. Due to fatigue, the patient had been taking iron tablets for several years without having a checkup of her body iron status. After 22 phlebotomies over a period of 300 days, the iron excess was finally removed.

Tables

Table 1. Patients’ Symptoms and Risk of Organ Involvement
 
Checking body iron status (serum ferritin and serum transferrin saturation) in patients with:
  Persistent fatigue without any obvious explanation
  Arthralgias, arthritis
  Elevated biochemical liver tests, liver disease
  Diabetes mellitus
  Hypogonadism, erectile dysfunction
  Cardiac disease
  Skin pigmentation

 

Table 2. Treatment of HFE-Hemochromatosis
 
Induction treatment
  Phlebotomy 300 - 500 mL at 1 - 2 weeks intervals, until serum ferritin is < 100 µg/L
  Check hemoglobin before each phlebotomy and ferritin after every fourth phlebotomy
Maintenance treatment
  Phlebotomy 1 - 4 times per year to maintain ferritin level at 50 - 100 µg/L and transferrin saturation < 60%
  Check hemoglobin, ferritin, and transferrin saturation before and 3 - 4 months after phlebotomy