hemochromatosis

  Thank you for answering my question.  Over the last 12 months I have experienced a variety of strange symptoms and have been seen by several specialists.  I have been diagnosed with neurocardiogenic syncope after a positive tilt table, gastric ulcers w/o H-pylori after upper GI endoscopy, and most recently, hemochromotosis.  In addition to high iron I have elevated bilirubin and low neutrophils.  I had a glucose tolerance test in which there was no rise in blood glucose, paradoxically, glucose dropped.  I am unable to tolerate high protein or high fat foods and cannot tolerate alcohol--all bring on nausea and malaise.  I am extremely sensitive to heat.  I am 30 years old and have always considered myself in excellent health.  Is it possible that all my symptoms and syndromes could be caused by the hemochromatosis?  Are there other possibilities my doctors should consider?
  Thank you again for your attention.
_______
Dear JSM:
Hemochromatosis mainly affect liver, heart, pancreas and endocrine systems (include pituitary, thyroid, testes etc.) There is inflammation and fibrosis due to abnormally high iron deposition of these organ systems. The damage and dysfunction of the above organ systems varies from patient to patient because of the heterogeneity of the disease and its manifestation.
Gastric ulcer without H. pylori infection can also occur, especially in those who taking various amount of non-steroidal anti-inflammatory analgesics (NSAIDS). Cigarette smoking, alcohol, systemic infection and emotional stress have all shown to be gastric or duodenal ulcer risk factors. Currently there is no published data to link hemochromatosis to gastric ulcer formation.
Hemochromatosis can cause heart disease and inflammation due to deposition of iron in the heart muscle and its conduction system leading to congestive heart failure and sometime arrhythmias. There is a possibility that your neurocardiogenic syncope is related to your hemochromatosis but one can not be certain without additional testing. It may require further invasive and complex cardiac electrophysiology testing to partially support the theory without benefit for clinical management.
Hemochromatosis most frequently affects the liver which leads to cirrhosis  and its complications. Elevated bilirubin in your case may possibly be related to hemochromatosis.  But elevated bilirubin is not specific just for liver disease caused by hemochromatosis. Any condition leading to liver damage and bile duct narrowing or obstruction can also cause elevations of bilirubin, e.g. viral hepatitis, primary biliary cirrhosis, sclerosing cholangitis and biliary stones to name a few.  Additional studies would be needed before attributing the bilirubin elevation to hemochromatosis,
Your negative glucose tolerance test means that you have intact pancreatic endocrine function (insulin secretion appropriate in response to sugar load). Hemochromatosis can also affect the pancreas causing damage of the exocrine glands secreting enzymes to digest dietary protein and fat that leading to your intolerance of high protein/high fat diet.
Although your symptoms and findings could be related to hemochromatosis, a full investigation is needed to excclude other diseases
This information is for educational purpose only. Always consult your doctor for your medical problems.
HFHSM.D.-rf
*keywords: hemochromatosis
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