Complications
Patients are more likely to develop cirrhosis if there are additional causes of liver damage present, such as alcohol use disorder or viral hepatitis.
Patients with end-stage liver disease due to haemochromatosis are candidates for liver transplantation. One year survival has been reported as 88.7% and five year survival as 77.5%.[74]
The risk of diabetes does not appear to be increased compared with the general population except in patients with haemochromatosis and cirrhosis.[28][30]
Treatment should be as for other patients with diabetes. However, management may be difficult for patients undergoing phlebotomy treatments because the HbA1c may overestimate glycaemic control.[45]
Although this is a chronic process, heart failure or conduction abnormalities from iron infiltration into the heart can present acutely with fluid overload or arrhythmias. Haemochromatosis can lead to cardiomyopathy and conduction abnormalities leading to arrhythmias.[46]
Patients presenting with heart failure or arrhythmias should undergo aggressive iron-lowering treatments.
Risk of HCC is increased in cirrhosis due to haemochromatosis. Whether the risk of cirrhosis-related HCC is higher in haemochromatosis than in other patients with cirrhosis has been debated.[75]
Rare cases of HCC have been reported in patients with haemochromatosis without cirrhosis and after completing phlebotomy. HCC surveillance in patients with cirrhosis should be performed with liver ultrasound every 6 months.[54]
The second most common endocrine disorder associated with the disease (after diabetes).[47]
Patients have decreased sexual drive and/or testicular atrophy.
Studies show that there is significant bone loss in patients with the disease, which cannot be solely a result of hypogonadism or cirrhosis.[76]
Patients with iron overload are at risk for infection with certain organisms, including Listeria monocytogenes, Yersinia enterocolitica, and Vibrio vulnificus.[77]
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