6) An 52 year-old Sicilian man is seen for abnormal iron studies. Repeat evaluation shows the following lab values. He denies alcohol abuse although you are skeptical. A genetic test for the HFE mutations C282Y and H63D is negative

• 6) An 52 year-old Sicilian man is seen for abnormal iron studies. Repeat evaluation shows the following lab values. He denies alcohol abuse although you are skeptical. A genetic test for the HFE mutations C282Y and H63D is negative

• LFTs: Fe/TIBC 260/330 ferritin 1200

• Total Protein 6.8 g/dl (6.7-8.6)

• Albumin 4.2 g/dl (4.1-5.3)

• T. Bili 1.2 mg/dl (.30-1.30)

• D Bili 0.1 mg/dl (.04-.38)

• AST 90 U/l (12-38)

• ALT 100 U/l (7-41)

• Alk Phos 82 U/l (33-96)

• What should you do?

• Tell him that the negative gene test means he does not have a primary iron overload disorder

• Repeat FE studies

• Tell him no further work-up is necessary because you believe he is using alcohol

• Perform a biopsy for histopathology and quantitative iron measurements

• None of the above