James C Barton1. 1. Southern Iron Disorders Center, Birmingham, AL, USA. ironmd@dnamail.com
Abstract
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.
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 HFEC282Y 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 HFEC282Y homozygosity after bariatric surgery, but their risk of developing iron deficiency may be diminished.