aetiology of iron overload

Last reviewed 10/2023

causes of iron overload

Iron overload syndromes can be divided into three groups

• hereditary Hemochromatosis
  
  
• HFE-related
• C282Y/C282Y
• C282Y/H63D
• other HFE mutations
  
  
• non–HFE-related
• hemojuvelin (HJV)
• transferrin receptor-2 (TfR2)
• ferroportin (SLC40A1)
• hepcidin (HAMP)
• African iron overload
  
  
• secondary Iron Overload
  
  
  • iron-loading anemias
    • thalassemia major
    • sideroblastic
    • chronic hemolytic anaemia
    • aplastic anemia
    • pyruvate kinase deficiency
    • pyridoxine-responsive anemia
      
      
• parenteral iron overload
• red blood cell transfusions
  • eg
    • parenteral iron overload in blood transfusions:
    • thalassamia major
    • sickle cell disease
    • myelodysplasia
      
      
• iron–dextran injections
• long-term hemodialysis
  
  
• excess dietary iron:
  • Bantu haemochromatosis
    
    
• chronic liver disease
• porphyria cutanea tarda
• hepatitis C
• hepatitis B
• alcoholic liver disease
• nonalcoholic fatty liver disease
• following portocaval shunt
  
  
• dysmetabolic iron overload syndrome
  
  
• miscellaneous
• neonatal iron overload
• aceruloplasminemia
• congenital atransferrinemia

A high alcohol intake is associated with more rapid development of haemochromatosis.

Reference:

• (1) Bacon BR et al. Diagnosis and management of hemochromatosis: 2011 practice guideline by the American Association for the Study of Liver Diseases. Hepatology. 2011l;54(1):328-43