Phillip B. Amidon, MD; Rhonda D. Jankovich, RN, BSN
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Amidon PB, Jankovich RD. Hereditary Hemochromatosis. Ann Intern Med. 2001;135:1091. doi: 10.7326/0003-4819-135-12-200112180-00020
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Published: Ann Intern Med. 2001;135(12):1091.
TO THE EDITOR:
We read with interest the findings of Beutler and associates (1), which demonstrated macrocytosis in patients with genetic hemochromatosis. We also noted the presence of macrocytosis in our small group of patients with hemochromatosis.
We evaluated a 50-year-old man for possible genetic hemochromatosis. The diagnosis was confirmed by liver biopsy, which documented increased iron staining and elevated hepatic iron and iron index. Our patient's initial complete blood count indicated macrocytosis that increased and then resolved as his iron stores were depleted by multiple phlebotomies. We ascribed this macrocytosis to cirrhosis. When we reviewed the laboratory data on other patients enrolled in our liver clinic who had a diagnosis of genetic hemochromatosis, we noted that all of them initially demonstrated macrocytosis, which resolved with phlebotomy. Macrocytosis was universal regardless of normal or elevated aspartate aminotransferase levels and varying degrees of hepatic fibrosis, from mild to none on liver biopsy.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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