{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:07:27Z","timestamp":1791994047946,"version":"4.4.0"},"reference-count":119,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","license":[{"start":{"date-parts":[[2022,6,14]],"date-time":"2022-06-14T00:00:00Z","timestamp":1655164800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatol Commun"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Iron overload disorders represent a variety of conditions that lead to increased total body iron stores and resultant end\u2010organ damage. An elevated ferritin and transferrin\u2010iron saturation can be commonly encountered in the evaluation of elevated liver enzymes. Confirmatory homeostatic iron regulator (\n                    <jats:italic toggle=\"yes\">HFE<\/jats:italic>\n                    ) genetic testing for C282Y and H63D, mutations most encountered in hereditary hemochromatosis, should be pursued in evaluation of hyperferritinemia. Magnetic resonance imaging with quantitative assessment of iron content or liver biopsy (especially if liver disease is a cause of iron overload) should be used as appropriate. A secondary cause for iron overload should be considered if\n                    <jats:italic toggle=\"yes\">HFE<\/jats:italic>\n                    genetic testing is negative for the C282Y homozygous or C282Y\/H63D compound heterozygous mutations. Differential diagnosis of secondary iron overload includes hematologic disorders, iatrogenic causes, or chronic liver diseases. More common hematologic disorders include thalassemia syndromes, myelodysplastic syndrome, myelofibrosis, sideroblastic anemias, sickle cell disease, or pyruvate kinase deficiency. If iron overload has been excluded, evaluation for causes of hyperferritinemia should be pursued. Causes of hyperferritinemia include chronic liver disease, malignancy, infections, kidney failure, and rheumatic conditions, such as adult\u2010onset Still's disease or hemophagocytic lymphohistiocytosis. In this review, we describe the diagnostic testing of patients with suspected hereditary hemochromatosis, the evaluation of patients with elevated serum ferritin levels, and signs of secondary overload and treatment options for those with secondary iron overload.\n                  <\/jats:p>","DOI":"10.1002\/hep4.2012","type":"journal-article","created":{"date-parts":[[2022,6,14]],"date-time":"2022-06-14T08:01:13Z","timestamp":1655193673000},"page":"1842-1854","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":149,"title":["Iron overload disorders"],"prefix":"10.1097","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8779-9422","authenticated-orcid":false,"given":"Christine C.","family":"Hsu","sequence":"first","affiliation":[{"name":"Medstar Georgetown University Hospital,Medstar Georgetown Transplant Institute,Washington,District of Columbia,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nizar H.","family":"Senussi","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology,University of New Mexico,Albuquerque,New Mexico,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kleber Y.","family":"Fertrin","sequence":"additional","affiliation":[{"name":"Division of Hematology,Department of Medicine,University of Washington,Washington,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8553-3652","authenticated-orcid":false,"given":"Kris V.","family":"Kowdley","sequence":"additional","affiliation":[{"name":"Liver Institute Northwest and Elson S. Floyd College of Medicine,Washington State University,Washington,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,6,14]]},"reference":[{"issue":"3","key":"hep42012-bib-0001-20241129","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.pharmthera.2007.02.001","article-title":"The role of transporters in cellular heme and porphyrin homeostasis","volume":"114","year":"2007","journal-title":"Pharmacol Ther"},{"issue":"2","key":"hep42012-bib-0002-20241129","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1097\/MOG.0b013e32831ef1f7","article-title":"Iron absorption and metabolism","volume":"25","year":"2009","journal-title":"Curr Opin Gastroenterol"},{"key":"hep42012-bib-0003-20241129","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1042\/bj3090745","article-title":"Characterization and partial purification of a ferrireductase from human duodenal microvillus 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