Training & Education - Treatment & Management Summary

Phlebotomy Treatment

• Therapeutic phlebotomy is the preferred treatment for reducing iron stores in hemochromatosis patients.
• For a patient who has no evident tissue or organ damage, proper disease management may result in normal long-term outcome and life expectancy.

Phlebotomy Regimen

• Clinicians must design phlebotomy treatment regimens that are individualized to each patient and account for age, gender, weight, health, and likelihood of compliance.

Monitoring Treatment

• Serum ferrinin levels should be measured after each additional one or two phlebotomy treatments once the value is ≤ 100 ng/mL.
• Careful monitoring of each patient throughout treatment is imperative. If treatment is too aggressive, anemia may result.

Lifetime Maintenance

• Continued lifetime monitoring is key to appropriate management.
• Phlebotomy should be performed throughout a patient’s life to keep the serum ferritin level between 25 and 50 ng/mL.

Patient Compliance

• Download a print-friendly "Phlebotomy Information for Patients with Hemochromatosis."
• Hemochromatosis cannot be treated by diet alone.
• The following dietary modifications for patients are suggested:
  • Avoid iron supplements.
  • Read the label of multivitamins to make sure they do not contain iron.
  • Limit vitamin C supplementation to 500 mg/day.
  • Avoid eating raw shellfish.
  • Avoid more than moderate alcohol consumption. Patients with liver damage should avoid alcohol.
• Download a print-friendly "Diet information for patients with hemochromatosis."

 

Test Your Knowledge

This is an optional self-quiz and is not required for continuing education credit.

Select the best answers below. If you need help, feel free to go back to Phlebotomy Treatment,  Monitoring Treatment, or Patient Compliance and review.

Question 1: Which of the following can indicate that iron depletion is complete? Hemoglobin concentration equals 14.0 mg/dL. Hematocrit is lower than 0.50 for more than 2 weeks (in patients who don’t have chronic anemia). Serum ferritin level is between 25 and 50 ng/mL.

Question 2: Once iron depletion is complete, how often should serum ferritin be monitored to maintain low body iron stores? At a minimum, yearly. At a minimum, every three years. At a minimum, every five years.

Question 3: Which of the following statements apply to patients undergoing phlebotomy treatments who have hemoglobin concentrations lower than 11 mg/dL or hematocrit lower than 0.33 before treatment? Phlebotomy is more efficient at removing iron in these patients. These patients are less likely to have symptoms of anemia. These patients are more likely to have symptoms of hypovolemia.

Question 4: In counseling hemochromatosis patients about diet, which of the following products would you suggest they avoid? Calcium-rich foods. Iron supplements or multivitamins with iron. Oranges.

 

   Patient Compliance           Family-based Detection