Editing Iron overload (section)

==Signs and symptoms==

Organs most commonly affected by hemochromatosis include the [[liver]], [[heart]], and [[endocrine gland]]s.<ref>{{cite journal |last1=Andrews |first1=Nancy C. |title=Disorders of Iron Metabolism |journal=New England Journal of Medicine |volume=341 |issue=26 |pages=1986–95 |year=1999 |pmid=10607817 |doi=10.1056/NEJM199912233412607}}</ref>

Hemochromatosis may present with the following clinical syndromes:
* liver: [[chronic liver disease]] and [[cirrhosis]] of the liver.<ref name="Murtagh, 2007">{{cite book|title=General Practice|author=John Murtagh|publisher=McGraw Hill Australia|year=2007|isbn=978-0-07-470436-3}}{{page needed|date=December 2010}}</ref>
* heart: [[heart failure]], [[cardiac arrhythmia]].<ref name="Murtagh, 2007" />
* hormones: diabetes (see below) and [[hypogonadism]] (insufficiency of the sex hormone producing glands) which leads to low sex drive and/or loss of fertility in men and loss of fertility and menstrual cycle in women.<ref name="Murtagh, 2007" />
* metabolism: [[diabetes]] in people with iron overload occurs as a result of selective iron deposition in islet [[beta cells]] in the [[pancreas]] leading to functional failure and cell death.<ref name="Selective iron deposition in pancre">{{cite journal |last1=Lu|first1=JP |title=Selective iron deposition in pancreatic islet B cells of transfusional iron-overloaded autopsy cases |journal=Pathol Int |volume=44 |pages= 194–99 |year=1994 |issue=3 |pmid=802561  |doi= 10.1111/j.1440-1827.1994.tb02592.x|s2cid=25357672 }}</ref>
* skeletal: [[arthritis]], from iron deposition in joints leading to joint pains. The most commonly affected joints are those of the hands, particularly the [[knuckle]]s or [[metacarpophalangeal joints]], wrists or [[radiocarpal joint]]s, elbow, hip, knee and ankle joints.<ref name="NEJM Olynyk" /><ref name="Bacon and Schrier, UpToDate">{{cite web|url=http://www.uptodate.com/contents/hemochromatosis-hereditary-iron-overload-beyond-the-basics|title=Patient information: Hemochromatosis (hereditary iron overload) (Beyond the Basics)|author=Bruce R Bacon, Stanley L Schrier|website=[[UpToDate]]|access-date=2016-07-14}} Literature review current through: Jun 2016. | This topic last updated: Apr 14, 2015.</ref> Risk factors for the development of arthritis in those with hemochromatosis include elevated iron levels ([[ferritin]] greater than 1000 or [[transferrin]] saturation greater than 50%) for an extended period of time, increasing age and concurrent advanced liver fibrosis.<ref name="NEJM Olynyk" />
* skin: melanoderma (darkening or 'bronzing' of the skin).<ref name="Bacon and Schrier, UpToDate" /><ref name="Brissot et al., Nat Rev Dis Prim 2018">{{cite journal |last1=Brissot |first1=P |last2=Pietrangelo |first2=A |last3=Adams |first3=PC |last4=de Graaff |first4=B |last5=McLaren |first5=CE |last6=Loréal |first6=O |title=Haemochromatosis. |journal=Nature Reviews. Disease Primers |date=5 April 2018 |volume=4 |pages=18016 |doi=10.1038/nrdp.2018.16 |pmid=29620054|pmc=7775623 }}</ref>
Hemochromatosis leading to secondary diabetes (through iron deposition in the insulin secreting beta cells of the pancreas), when combined with a bronzing or darkening of the skin, is sometimes known as "bronze diabetes".<ref name="Diabetes.org.uk">{{cite web |title=Haemochromatosis and diabetes |url=https://www.diabetes.org.uk/diabetes-the-basics/related-conditions/haemochromatosis-diabetes |website=Diabetes UK |language=en}}</ref>