Expected Benefits of Phlebotomy Treatment
At diagnosis, degree of organ damage is the major determinant of patient prognosis.

This table summarizes the expected benefits of treatment among hemochromatosis patients completing therapeutic phlebotomy treatment:

Pretreatment State Expected Benefit

No symptoms

 Prevention of complications of iron overload; normal life expectancy.
Weakness, fatigue, lethargy Resolution or marked improvement if iron related.
Elevated serum concentrations of hepatic enzymes Resolution or marked improvement.
Diarrhea Cessation if iron related.
Hepatomegaly Resolution often occurs.
Hepatic cirrhosis No change or slower progression of liver failure.
Right-upper quadrant pain Resolution or marked improvement.
Arthropathy Some improvement in arthralgias, change in joint deformity; progression is sometimes seen.
Hypogonadotrophic hypogonadism Resolution is rare.
Diabetes mellitus Occasional improvement, if iron related.
Hyperthyroidism, hypothyroidism Resolution is rare.
Cardiomyopathy Resolution sometimes occurs.
Hyperpigmentation Resolution usually occurs.
Hyperferritinemia Resolution.
Hyperferremia Little change to minor improvement.
Excess absorption and storage of nonferrous metals (cobalt, manganese, zinc, lead) Little or no change.
Note: Increased risk for primary liver cancer can be reduced if the liver is precirrhotic.

(Barton JC 1998 and 2000)