Summary
Definition
History and exam
Key diagnostic factors
- fatigue
- weakness
- lethargy
- arthralgias
- hepatomegaly
- diabetes mellitus
- impotence in males
- amenorrhea
- loss of libido
- skin pigmentation
Other diagnostic factors
- congestive heart failure
- arrhythmias
- porphyria cutanea tarda
Risk factors
- middle age
- male sex
- white ancestry
- family history
- supplemental iron
Diagnostic tests
1st tests to order
- serum transferrin saturation
- serum ferritin
Tests to consider
- HFE mutation analysis
- serum-based fibrosis tests/transient elastography
- MRI liver
- liver biopsy
- LFTs
- fasting blood sugar
- echocardiogram
- ECG
- MRI heart and other organs
- testosterone, FSH, and LH assays
- bone densitometry
Treatment algorithm
stage 0 disease (C282Y homozygous)
stage 1 disease (C282Y homozygous)
stage 2, 3, or 4 disease (C282Y homozygous)
not C282Y homozygous
Contributors
Authors
Kyle E. Brown, MD, Msc, FAASLD
Professor of Internal Medicine - Gastroenterology and Hepatology
Professor of Radiation Oncology
University of Iowa Carver College of Medicine
Iowa City
IA
Disclosures
KEB declares that she has no competing interests.
Acknowledgements
Dr Kyle E. Brown would like to gratefully acknowledge Dr Rebecca Fischer Connor, the previous contributor to this topic. RFC declares that she has no competing interests.
Peer reviewers
Pierre Brissot, MD
Professor of Medicine and Chief of Liver Disease Department
University Hospital Pontchaillou
Rennes
France
Disclosures
PB declares that he has no competing interests.
William E. Cayley, MD MDiv
Associate Professor
Department of Family Medicine
University of Wisconsin
Madison
WI
Disclosures
WEC declares that he has no competing interests.
Differentials
- Iron overload from chronic transfusion
- Hepatitis B
- Hepatitis C
More DifferentialsGuidelines
- Clinical practice guidelines on haemochromatosis
- ACG clinical guideline: hereditary hemochromatosis
More GuidelinesPatient information
Diabetes type 2: should I take insulin?
Heart failure
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