Hemochromatosis and hemosiderosis are two conditions associated with having too much iron in the body. In some cases, this can affect the liver.
Hemochromatosis is a condition where a person has too much iron in their body. In hemosiderosis, iron deposits in organs such as the liver, pancreas, and skin.
These conditions have multiple causes. Hereditary hemochromatosis means the body absorbs too much iron, while in secondary hemochromatosis, a person receives too much iron from blood transfusions or infusions.
Having too much iron in the body can damage the liver.
In this article, we discuss hemosiderosis versus hemochromatosis and how they affect the liver.
Hemochromatosis occurs when iron builds up in the body. The body regulates iron absorption because it cannot eliminate excess iron.
Iron can accumulate in certain organs and cause organ damage.
Hemochromatosis can affect the following:
- ovaries and testicles
- pituitary gland
Iron overload can occur in three ways:
- A hereditary condition that changes how the body processes iron.
- Getting too much iron from blood transfusions or infusions.
- In rare cases, when a person ingests too much iron.
This condition causes the body to absorb more iron than usual.
Hemosiderosis usually occurs when people receive repeated blood transfusions. The body becomes overloaded with iron from the transfused red blood cells. It frequently occurs in people with underlying health conditions requiring many blood transfusions, such as sickle cell disease, aplastic anemia, and thalassemia.
With so much iron in the body, it accumulates, and the body cannot eliminate it.
Having too much iron in the body damages the liver over time.
When iron accumulates in the liver, it can cause damage.
Even though a person may not have symptoms of hemochromatosis, the liver may not work correctly. For example, people with hemochromatosis who have no symptoms may have abnormal liver function tests.
In fully established hemochromatosis, people may already have cirrhosis or scarring of the liver. Some people may have hepatomegaly, which is an enlargement of the liver.
- skin changes, such as yellowing of the skin
- fluid accumulation (ascites) in the abdomen
- brain disease (encephalopathy)
- elevated liver enzymes
- joint pain
Left untreated, having too much iron in the liver can lead to liver failure. It can also increase a person’s chances of developing liver cancer.
Symptoms of hemochromatosis
Doctors may only diagnose hemochromatosis when the condition begins to affect multiple organs.
At first, people may have severe fatigue, lethargy, and joint pain.
Later, if deposits form in the liver, people may have jaundice and liver function abnormalities. When liver dysfunction occurs, they may have:
- belly pain
- enlarged liver
- scar tissue formation (cirrhosis)
- high blood pressure in the liver (portal hypertension)
- fluid collection in the belly (ascites)
- enlarged spleen
Doctors diagnose hemochromatosis through blood test results. Medical and family history and physical exams may also help when diagnosing hemochromatosis.
Certain symptoms may signal hemochromatosis, but people may not always have symptoms.
During a physical exam, doctors will check for the following:
- changes in skin color
- liver or spleen enlargement
- tenderness in the belly
- swelling and tenderness of the joints
Doctors will check a person’s blood test results to help diagnose hemochromatosis. They will analyze:
- iron levels
- transferrin levels (the protein that transports iron in the blood)
- iron to transferrin ratio
- ferritin levels (the protein that stores iron in the liver)
People with hemochromatosis will repeat these blood tests during treatment. Doctors analyze the results of repeated blood tests to check if the treatment is working.
Doctors can also check the blood for genetic mutations that cause hemochromatosis.
A biopsy involves taking a small piece of the liver to examine it under a microscope. A pathologist can check for iron deposits in the liver as well as the extent of any scar tissue.
Additionally, doctors can use an MRI to detect iron overload. Certain imaging scans can determine how much iron is in the liver.
Without treatment, hemochromatosis and hemosiderosis can cause many organs to stop working correctly, such as the liver, heart, and pancreas.
One treatment for people with hemochromatosis is phlebotomy. This is a simple, inexpensive, and safe procedure.
During phlebotomy, a doctor or healthcare professional will remove about a pint of blood at a time on a regular schedule.
The amount of blood removed during phlebotomy depends on the person’s iron level. Phlebotomies can help relieve symptoms of hemochromatosis and prevent any complications.
People with hemosiderosis from repeated blood transfusions cannot have phlebotomies, as this would involve removing the essential transfused blood.
They require medications to trap the excess iron and eliminate it through the urine. These drugs are called iron-chelating agents. They come in oral form or as an injection.
Different iron chelators doctors
- deferasirox (Jadenu)
- deferiprone (Ferriprox)
- deferoxamine (Desferal)
Without treatment, hemochromatosis and hemosiderosis can lead to complications.
Untreated iron overload can cause cirrhosis or scarring of the liver. When scar tissue replaces healthy tissue in the liver, it stops functioning correctly.
Scar tissue can also block blood flow into the liver. Eventually, cirrhosis can cause liver failure. Some people with liver failure need a transplant.
Cirrhosis of the liver can
Other organs affected by iron overload include the following:
- reproductive organs
Untreated hemochromatosis or hemosiderosis can cause heart failure, arthritis, diabetes, and a decreased sex drive.
Hemochromatosis and hemosiderosis occur when the body has too much iron.
In rare cases, this can happen because a person gets too much iron through their diet. It can also occur because of repeated blood transfusions.
Without treatment, excess iron in the body can damage organs, including the liver.
To treat hemochromatosis, doctors may prescribe regular phlebotomies.
Hemosiderosis is a type of hemochromatosis that occurs in people receiving repeated transfusions. People with hemosiderosis may need iron-chelating drugs that remove iron from the body.