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March 1964

Desferrioxamine Effect on Iron Excretion in Hemochromatosis

Arch Intern Med. 1964;113(3):435-441. doi:10.1001/archinte.1964.00280090121020

Without treatment hemochromatosis follows an inexorable downhill course over a period of months to years, eventuating in death due to heart failure, hepatic coma, ruptured esophageal varices, carcinoma of the liver, intercurrent infection, or sudden shock. Early treatment of hemochromatosis embraced: (1) insulin for the management of diabetes mellitus; (2) rest and adequate diet for liver impairment; and (3) salt restriction, digitalis, diuretics, and quinidine for cardiac failure and arrhythmias. No direct attempt had been made to remove accumulated iron from the involved tissues until phlebotomy was shown to be an effective method for removing iron from the body.1-4 Approximately 9 to 13 gm of iron a year can be withdrawn if phlebotomies are done every seven to ten days. Crosby 5 has shown that as much as 55 liters of blood can be removed in 11 months (27.5 gm of iron) in treating severe complications due to hemochromatosis.