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Secondary Iron Overload and the Liver: A Comprehensive Review

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XIA & HE PUBLISHING INC
DOI: 10.14218/JCTH.2022.00420

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Iron overload; Hemochromatosis; Cirrhosis; Hepatocellular carci-noma; Thalassemia

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Iron overload is a condition characterized by excessive iron deposit in organs, primarily the liver, leading to liver morbidity and mortality. It can be divided into primary and secondary causes, with secondary iron overload being more prevalent and associated with diverse causes across different geographic regions. The main causes of secondary iron overload are iron-loading anemias and chronic liver disease. This review provides an overview of the causes, pathophysiology, liver-related outcomes, disease outcomes, and treatments of secondary iron overload.
Iron overload is a condition involving excessive iron deposit in various organs, the liver being the main target organ for iron deposition and overload which are associated with significant liver morbidity and mortality. Iron overload can be categorized into primary and secondary causes. Primary iron overload, so-called hereditary hemochromatosis, is a well recognized disease with available standard treatment recommendations. However, secondary iron overload is a more diverse disease with many unclear areas to be explored. Secondary iron overload is more prevalent than primary iron overload and occurs as a consequence of various causes which differ significantly across geographic regions. The main causes of secondary iron overload are iron-loading anemias, and chronic liver disease. The liver-related outcomes, patient outcomes, and treatment recommendations in these patients differ depending on the cause of iron overload. This review summarizes the causes, pathophysiology, liver-related outcomes, disease outcomes, and treatments of secondary iron overload.

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