20th August 2020

A 39-year old man is diagnosed with haemochromatosis following the development of progressive arthralgia and fatigue

A 39-year old man is diagnosed with haemochromatosis following the development of progressive arthralgia and fatigue. He was diagnosed with HIV two years ago and has an undetectable viral load. He is an ex-intravenous drug user. His blood results are below:

• Hb: 143 (115-165g/L)
• WCC: 5.2×10⁹ (3.6-11.0×10⁹/L)
• Platelets: 144×10⁹ (140-400×10⁹/L)
• Na: 135 (133-146mmol/L)
• K: 4.2 (3.5-5.3mmol/L)
• Ca (adjusted): 2.4 (2.2-2.6mmol/L)
• Urea: 7.2 (2.5-7.8mmol/L)
• Creatinine: 48 (45-84μmol/L)
• HbA1c: 41 (<42mmol/mol)
• Vitamin B12: 650 (180-1000pg/ml)
• Folate: 8.9 (>4.0 ng/ml)
• Transferrin saturation: 82 (25-45%)
• Serum ferritin: 887 (15-200ug/L)

How would you manage this patient’s haemochromatosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.