Hemochromatosis, HFE C282Y homozygosity, and bariatric surgery: report of three cases.
BACKGROUND
Iron absorption is decreased in some individuals who have undergone bariatric surgery.


METHODS
We evaluated measures of iron metabolism and therapeutic phlebotomy in 3 adults with hemochromatosis and HFE C282Y homozygosity who underwent bariatric surgery.


RESULTS
1 male and 1 female had surgery before diagnosis of hemochromatosis (jejuno-ileal bypass and Roux-en-Y gastric bypass, respectively); neither had iron overload. Another man was treated with serial phlebotomy to induce iron depletion; later, he underwent Roux-en-Y gastric bypass. His maintenance phlebotomy requirement for hemochromatosis decreased substantially (on average approximately 1 unit each 71 days before surgery, and approximately 1 unit each 173 days after surgery). None of these patients developed iron deficiency, and none took supplemental iron.


CONCLUSIONS
Iron absorption is decreased in some patients with hemochromatosis and HFE C282Y homozygosity after bariatric surgery, but their risk of developing iron deficiency may be diminished.
Barton
James C
JC
Southern Iron Disorders Center, Birmingham, AL, USA. ironmd@dnamail.com
D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects / Q000379:methods; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects* / Q000379:methods; D005786:Gene Expression Regulation; D006432:Hemochromatosis / Q000209:etiology* / Q000235:genetics / Q000503:physiopathology; D000071020:Hemochromatosis Protein; D015395:Histocompatibility Antigens Class I / Q000235:genetics*; D006720:Homozygote; D006801:Humans; D008297:Male; D008565:Membrane Proteins / Q000235:genetics*; D008875:Middle Aged; D020125:Mutation, Missense; D009767:Obesity, Morbid / Q000175:diagnosis / Q000601:surgery*; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000175:diagnosis*; D011379:Prognosis; D018570:Risk Assessment; D012494:Sampling Studies; D016896:Treatment Outcome; D015431:Weight Loss
C103673:HFE protein, human; D000071020:Hemochromatosis Protein; D015395:Histocompatibility Antigens Class I; D008565:Membrane Proteins