Lawrie W. Powell, MD, PhD; D. Keith George, MBChB, MRCP; Sharon McDonnell, MD
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Powell LW, George DK, McDonnell S. Diagnosis of Hemochromatosis. Ann Intern Med. 1999;131:311-312. doi: 10.7326/0003-4819-131-4-199908170-00019
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Published: Ann Intern Med. 1999;131(4):311-312.
Our discussion of the laboratory criteria for hemochromatosis was clearly in the context of an otherwise healthy person or one with clinical features suggestive of the disease. We stated that in this situation “the serum ferritin level defines the point at which hemochromatosis is expressing iron overload and treatment should be initiated.” It is then that the serum ferritin level exquisitely reflects body iron stores. Other conditions can indeed cause an elevation in serum ferritin level out of proportion to iron stores, and we listed inflammation, infection, and cancer because they can complicate hemochromatosis. Renal disease is rare in hemochromatosis, and end-stage renal disease would be entirely unrelated. It is also noteworthy that most studies of chronic renal disease assess body iron stores by bone marrow iron. This is not applicable to hemochromatosis, in which hepatic iron concentration is increased while bone marrow iron stores are normal.
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