Review Question - QID 106248

This patient's iron studies are consistent with hemochromatosis. Hemochromatosis is due to excess iron absorption in the intestines.

Hemochromatosis causes excess iron absorption and subsequent deposition in nearly all tissues. The disease is autosomal recessive and has a slow course. It is much more common in men and typically presents in the fifth decade. In affected women, the disease typically presents 10-20 years post-menopause. Iron studies reveal increased serum iron, markedly increased transferrin saturation, increased ferritin, and decreased TIBC. Of note, transferrin saturation is the ratio of iron over TIBC x 100 (in this patient: 200/220).

Illustration A shows iron overload in the liver. Note iron deposition within hepatocytes.

Incorrect Answers:
Answer 1: Chronic inflammation causes anemia of chronic disease. Labs will show a decreased iron and TIBC but an elevated ferritin.

Answer 3: Iron deficiency causes iron deficiency anemia. Serum iron and transferrin saturation are decreased.

Answer 4: Lead poisoning causes sideroblastic anemia. Lead poisoning produces similar iron studies to hemochromatosis, though ferritin is often within the normal range and transferrin saturation is less drastically elevated. Also, erythrocyte protoporphyrin levels would likely be elevated.

Answer 5: This patient is too old for pregnancy, though pregnancy would produce an increase in TIBC and a decrease in transferrin saturation.