Transfusional Haemosiderosis Simulating

Haemochromatosis is a disease occurring predominantly in men, and characterized by excessive deposition of iron in the tissues, coexisting with skin pigmentation and hepatic, pancreatic, and testicular fibrosis. The condition is described by Sheldon (1935) in whose monograph 311 cases are reviewed. Parenteral iron given in excess of requirements will be deposited in the tissues, since, with the exception of menstruation in women, the body has no normal mechanism for the elimination of significant amounts of iron. Except in haemorrhagic states, similar iron deposition will follow multiple blood transfusions. The distribution of this iron and its effect on the tissues is a study of considerable theoretical interest and of some practical importance. On the existence of a type of haemochromatosis known as acquired, secondary, exogenous, or transfusional, opinion is divided. Schwartz and Blumenthal (1948), Aufderheide, Horns, and Goldish (1953), Goldish and Aufderheide (1953), Morningstar (1955), and Pengelly and Jones (1956) have reported cases described as haemochromatosis caused by multiple blood transfusions. That multiple blood transfusions alone can cause haemochromatosis is denied by Wyatt, Mighton, and Moragues (1950), Cottier (1952), Kleckner, Baggenstoss, and Weir (1954), Kleckner, Kark, Baker, Chapman, Kaplan, and Moore (1955), and by Dubin (1955). The following case is reported of a woman who, having received 150 "pints" of blood for an aplastic anaemia, developed haemosiderosis seen as pigmentation of the skin and detectable in the sternal marrow and mucosal glands of the stomach. Post-mortem examination showed an extensive haemosiderosis with hepatic and pancreatic fibrosis.