What medical conditions can cause secondary hemochromatosis (iron overload)?

From the Guidelines

Secondary hemochromatosis can be caused by several medical conditions, including iron-loading anemias, chronic liver disease, parenteral iron overload, and miscellaneous causes, as outlined in the 2011 practice guideline by the American Association for the Study of Liver Diseases 1. These conditions lead to iron overload in the body, which can cause organ damage and dysfunction if left untreated. Some of the specific medical conditions that can cause secondary hemochromatosis include:

• Iron-loading anemias, such as thalassemia major, sideroblastic anemia, and chronic hemolytic anemia
• Chronic liver diseases, such as hepatitis C, hepatitis B, alcoholic liver disease, and nonalcoholic fatty liver disease
• Parenteral iron overload, which can occur due to red blood cell transfusions, iron-dextran injections, or long-term hemodialysis
• Miscellaneous causes, such as porphyria cutanea tarda, dysmetabolic iron overload syndrome, and rare genetic disorders like aceruloplasminemia and atransferrinemia. It is worth noting that oral iron ingestion does not typically lead to iron overload, except in individuals with genetically predisposed conditions or those with ineffective erythropoiesis, as stated in the study 1. Additionally, a study published in the Journal of the American College of Cardiology in 2010 also highlights the association of iron overload cardiomyopathy with hereditary hemochromatosis, porphyria cutanea tarda, chronic liver disease, and ineffective erythropoiesis 1. However, the most recent and highest quality study, which is the 2011 practice guideline by the American Association for the Study of Liver Diseases 1, provides a comprehensive classification of iron overload syndromes and is therefore the primary basis for this recommendation. The management of secondary hemochromatosis should focus on treating the underlying condition, reducing iron intake, and removing excess iron from the body to prevent organ damage and improve quality of life 1.

From the Research

Medical Conditions Causing Secondary Haemochromatosis

The following medical conditions can cause secondary haemochromatosis:

• Thalassemia syndromes 2, 3
• Myelodysplastic syndrome (MDS) 2, 3
• Myelofibrosis 3
• Sideroblastic anemias 3
• Sickle cell disease 3, 4
• Pyruvate kinase deficiency 3
• Chronic liver diseases 3, 5
• Iron-loading anemias 5

Key Characteristics of Secondary Haemochromatosis

Secondary haemochromatosis is characterized by:

• Ineffective erythropoiesis leading to increased duodenal uptake of iron 2
• Chronic transfusion dependence, resulting in excess iron intake 2
• Organ damage due to iron overload 2, 3, 5