Gastric bypass surgery as an intervention for obese patients with hemochromatosis

The patient is a 40-year-old Caucasian obese man who was diagnosed with hereditary hemochromatosis in November of 2004. He originally presented with fatigue and underwent blood testing that showed a serum iron level of 128 µg/dl (22.91 µmol/l), a total iron-binding capacity (TIBC) of 307 µg/dl (54.9 µmol/l), a ferritin value of 733 ng/ml (1647 pmol/l) and an iron saturation of 42%. The patient had a family history of hemochromatosis and genetic testing demonstrated homozygosity for HFE C282Y. He started receiving maintenance phlebotomies every 3 months to prevent iron overload and to maintain ferritin values <50 ng/ml. For treatment of his obesity, he underwent a gastric bypass surgery in June of 2008. Three months later, the serum ferritin level was 61 ng/ml (137 pmol/l) and he required phlebotomy. In December of 2008, the monitored ferritin level was 36 ng/ml (80.8 pmol/l). Since then, the patient has been evaluated every 3 months and has not required any new phlebotomies over the past 2 years. He has no symptoms of iron deficiency and feels well. …