Secondary iron overload may also be due to porphyria cutanea2013.03.31

In such cases, those who have received >20 transfusions (for example, patients with sickle cell disease, thalassaemia major, aplastic anaemia, or myelodysplasia) are at risk of iron overload and in the long term may develop cardiac, hepatic, or endocrine dysfunction. Secondary iron overload may also be due to porphyria cutanea tarda, a hepatic porphyria presenting with cutaneous photosensitivity and liver dysfunction due to hepatic iron deposition.Primary iron overload (hereditary haemochromatosis) This is iron accumulation due to inheritance of mutations in the HFE gene on chromosome 6. This autosomal recessive disorder is the commonest single gene disorder in northern European populations (estimated prevalence 0.4%), but is far less common in other populations.6 It causes excessive absorption of dietary iron pandora jewelry, but is often asymptomatic and unrecognised in primary care.9 10 Associated morbidities (hepatic, endocrine, cardiac) are serious and preventable: timely diagnosis and treatment are important.Clinical assessment in primary careInitial clinical assessment of any patient with hyperferritinaemia should first consider reactive causes (box 2); if these are clearly present, further investigation may be unnecessary.

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