A 34-year-old man with sickle cell disease (SCD), end-stage renal disease, secondary hemochromatosis
, multiple prior strokes, seizures, polymicrobial line infections, and line-associated deep vein thromboses presented initially with hypotension and seizure-like activity.
Prolonged and excessive iron ingestion and repeated blood transfusions that take place with hypoproliferative anemia and thalassemia may result in secondary hemochromatosis
Because patients with chronic liver diseases like hepatitis C may also harbor mutations associated with hereditary hemochromatosis, it may be impossible to distinguish hereditary from HCV-related or other causes of secondary hemochromatosis
without genetic testing.
The patient received frequent blood transfusions and monthly intravenous deferoxamine for secondary hemochromatosis
Multiple organs had evidence of marked hemosiderin deposition consistent with secondary hemochromatosis
(Figures 1 and 2).
Multiple blood transfusions at that time were complicated by hepatitis C with cirrhosis and secondary hemochromatosis
, treated at home with twice weekly deferoxamine by subcutaneous central venous catheter.