By khaled on Sunday, 15 March 2015
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a patient with end stage renal disease on dialysis for 3 years. his anemia was managed by erythropoeitin 12000  weekly , with iron sucrose 100 mg 3 times weekly.

his new iron profile shows TSAT 31 % , while his ferritin is 1600 ng/ml.

the patient 2 months ago started to feel severe abdominal distension , for which abdominal ultrasound was done . it shows a degree of liver cirrhosis , as well as ascites.

Is this related to hemochromatosis?

Hi Khaled,

Thanks for your question.

These lab parameters are very common in patients on dialysis who are receiving iron and who might have underlying inflammation. Therefore, my instinct is that this is not hemochromatosis. Having said that, if the there is unexplained cirrhosis, it might be reasonable to evaluate with genotyping and/or MRI (or even liver biopsy). I have attached the UpToDate algorithm for hemochromatosis workup based on various parameters:

Regards,

Dr. Jordan Weinstein
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10 years ago
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