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What parameters would you use to monitor and interpret iron levels in a hemochromatosis patient where ferritin is unreliable due to underlying chronic inflammation?

How would your recommendation change if the patient has H63 homozygous mutation?
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For hereditary hemochromatosis, how often would you repeat MRI liver iron quantification when patients are at goal ferritin?

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2 Answers
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Hematology · Gundersen Health
Answered on

The biggest question in these situations is whether the patient truly has iron overload vs. just high ferritin. If iron sat is not elevated, true iron overload is very unlikely. If both ferritin and iron sat are elevated, but they don't have a homozygous C282Y genotype, I make sure that the patient ...

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Mednet Member
Mednet MemberInvited Expert
Hematology · Rochester General Hospital
Answered on · Updated on

H63D homozygosity is not usually associated with iron overload so a high ferritin in that circumstance is likely from inflammation or liver injury.

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