The body requires iron to produce red blood cells and other iron-containing substances. Dietary iron absorbed from the intestine serves as the natural source to meet metabolic needs. The body conserves iron and has no mechanism for ridding itself of excess amounts. Various hereditary and acquired conditions and factors can cause excess iron accumulation, leading to overload and tissue damage.
Hereditary Hemochromatosis Type 1
Hemochromatosis type 1, also known as HFE-associated hereditary hemochromatosis, is an inherited disorder that causes abnormally increased absorption of dietary iron from the intestine. Symptoms of iron overload with hemochromatosis type 1 typically occur after age 40 in males and after menopause in females, notes Dr. Kris Kowdley and colleagues in a chapter on hereditary hemochromatosis in the online text "Gene Reviews." Liver disease, heart failure, erectile dysfunction, joint problems and diabetes commonly occur in adults with untreated hemochromatosis type 1. Kowdley and colleagues report that approximately one-third of the Caucasian population are carriers of the hemochromatosis type 1 gene, or HFE. Carriers do not exhibit abnormal iron absorption, but can pass the HFE gene to their children.
Hereditary Juvenile Hemochromatosis
Juvenile hemochromatosis, also known as hemochromatosis type 2, is an uncommon inherited form of iron overload caused by a defect in the HJV gene. In contrast to hemochromatosis type 1, juvenile hemochromatosis typically presents in late childhood to early adulthood, as noted in "Gene Reviews." Delayed or absent sexual development and heart disease commonly occur. The disease course of juvenile hemochromatosis is typically more severe and rapidly progressive than that of hemochromatosis type 1.
Neonatal Hemochromatosis
Neonatal hemochromatosis is a rare condition in which iron overload begins while a baby develops in the womb. As noted by "Genetics Home Reference," published online by the U.S. National Library of Medicine, liver damage due to excessive iron accumulation is typically present at birth. Neonatal hemochromatosis progresses rapidly, often proving fatal.
Inherited Anemias
"The Merck Manual for Healthcare Professionals" reports that people with inherited anemias, including sickle cell anemia, sideroblastic anemia, congenital hemolytic anemia and thalassemia, often develop iron overload. Increased intestinal iron absorption and serial transfusions eventually lead to tissue-damaging overload. As with hereditary forms of hemochromatosis, the heart, endocrine organs and liver are most prone to iron overload damage.
Chronic Liver Disease
Certain types of chronic liver diseases may lead to iron overload. In a 2007 review article on iron overload published in "Modern Pathology," Dr. Kenneth Batts reports that people with alcoholic liver disease, chronic viral hepatitis and other forms of cirrhosis often accumulate excess iron in the liver.
Blood Transfusions
People who receive blood transfusions on a regular basis often develop iron overload, notes the National Heart, Lung and Blood Institute. Patients with various forms of chronic anemia and kidney failure commonly require periodic blood transfusions, placing them at high risk for iron overload.
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