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August 1963

Idiopathic Hemochromatosis: Genetic or Acquired?

Author Affiliations


Assistant Professor of Pathology, Harvard Medical School; Associate Pathologist, Mallory Institute of Pathology.

From the Mallory Institute of Pathology, Boston City Hospital, and the Department of Pathology, Harvard Medical School.

Arch Intern Med. 1963;112(2):184-190. doi:10.1001/archinte.1963.03860020082010

A tentative suggestion was made 36 years ago by Sheldon 1 that hemochromatosis might be a genetic disease. This idea has since been accepted with increasing firmness until it may now appear as temerity even to question it. Yet when all the facts are examined the conclusion is inescapable to me that hemochromatosis is an acquired condition.

Two early assumptions set our thinking about hemochromatosis off on the wrong foot. The first was that it was a disease suigeneris,2,3 the result of pancreatic, liver, or hematologic disease, without considering fully its relationship to portal cirrhosis. Because of this assumption an interesting bibliography has accumulated in which certain phenomena have been reported to be peculiar to hemochromatosis, such as abdominal pain,4 heart disease,5 and labile diabetes, but such reports have been without controls. The second assumption was that the diet of afflicted persons contained normal or

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