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IRON OVERLOAD

DDx
Treatment

Differential Diagnosis
1. Homozygous hereditary hemochromatosis
2. Anemia associated with ineffective erythropoiesis (with or without transfusions)
Hereditary & acquired sideroblastic anemia
Thalassemia (major & intermedia)
Dysmyelopoietic refractory anemias
Congenital dyserythropietic anemias (HEMPAS & others)
3. Hereditary hemolytic anemias without transfusion
Hereditary spehrocytosis
Thalassemia minor
4. Intemperate ingestion
Chronic iron tablet ingestion
5. Transfusional iron overload
Severe hemolytic anemias
6. African iron overload

Treatment
1. Phlebotomy
Goal is to make the patient iron deficient. usually we aim for a ferritin at or below 50.

2. Iron-Chelation Therapy
We usually use this method in patients who cannot undergo phlebotomy; for example, in patients who get iron overloaded secondary to frequent blood transfusions.
DEFEROXAMINE 40 mg/kg/day infused subcutaneously.

Facts about IRON:
The obligatory daily loss of iron is 1 mg. This is usually due to the iron lost from desquamated epithelial cells.