Treatment of Iron Overload

• Hereditary Hemochromatosis

• One phlebotomy (removal of 500 mL of blood) weekly or biweekly

• Check hematocrit prior to each phlebotomy; allow hematocrit to fall by no more than 20 percent of prior level

• Check serum ferritin level every 10 to 12 phlebotomies

• Stop frequent phlebotomy when serum ferritin falls below 50 ng/mL

• Continue phlebotomy at intervals to keep serum ferritin to between 25 and 50 ng/mL

• Avoid vitamin C supplements

• Secondary Iron Overload due to Dyserythropoiesis

• Deferoxamine (Desferal) at a dose of 20 to 40 mg/kg body weight per day

• Consider follow-up liver biopsy to ascertain adequacy of iron remova

• lAvoid vitamin C supplements

• Reproduced with permission from the American Association for the Study of LiverDiseases. Tavill, AS, Hepatology 2001; 33:1321.