Does hereditary hemochromatosis (HH) cause painful burning dysesthesia in the feet?

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From the Research

Hemochromatosis can potentially cause painful burning dysesthesia in the feet, though it's not among the most common neurological manifestations of the disease. Hemochromatosis is a disorder that causes excessive iron absorption and accumulation in various organs, including the liver, heart, and pancreas. When iron deposits affect peripheral nerves, patients may experience neuropathic symptoms including burning pain, tingling, and numbness in the feet. This peripheral neuropathy occurs because excess iron can cause oxidative stress and direct damage to nerve fibers, as discussed in the context of iron homeostasis and its regulation by hepcidin and ferroportin 1. The dysesthesia typically develops gradually as iron accumulation progresses over time.

Key Points to Consider

  • Hemochromatosis is characterized by systemic iron overload of genetic origin, leading to potential damage to various organs, including the peripheral nerves 2.
  • The most common form of hemochromatosis is due to homozygous mutations in HFE, but non-HFE forms also exist, and all can lead to iron accumulation and potential neuropathic symptoms 3.
  • Diagnosis of hemochromatosis involves clinical examination, assessment of plasma iron parameters, imaging, and genetic testing, with phlebotomy being the mainstay of treatment 4.
  • Reducing body iron stores through regular phlebotomy can help prevent further nerve damage and may improve symptoms in some cases, although established neuropathy might not completely resolve even with iron reduction therapy 5.

Management and Treatment

Treatment focuses on reducing body iron stores through regular phlebotomy (blood removal), which can help prevent further nerve damage and may improve symptoms in some cases. However, established neuropathy might not completely resolve even with iron reduction therapy. If you're experiencing burning pain in your feet and have hemochromatosis, it's essential to discuss these symptoms with your healthcare provider, as they may recommend specific pain management strategies alongside iron reduction therapy. Lifestyle modifications and management of comorbid conditions are also crucial in the overall management of patients with hemochromatosis, as emphasized in recent guidelines 5.

References

Research

Haemochromatosis.

Nature reviews. Disease primers, 2018

Research

Hereditary Hemochromatosis: Rapid Evidence Review.

American family physician, 2021

Research

Hemochromatosis: genetics and pathophysiology.

Annual review of medicine, 2006

Research

Diagnosis and management of hereditary hemochromatosis: lifestyle modification, phlebotomy, and blood donation.

Hematology. American Society of Hematology. Education Program, 2024

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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