Medicine · Liver Disease (Cirrhosis, Hepatitis, Autoimmune, Wilson's, Hemochromatosis)

A 50-year-old man with hereditary hemochromatosis (HFE C282Y homozygous) has completed initial weekly phlebotomy. His serum ferritin is now 40 ng/mL, transferrin saturation 45%, and he is asymptomatic. What is the recommended maintenance phlebotomy schedule?

  • A Every 6 months
  • B Every 2 to 4 months
  • C Every 1 month
  • D Every 2 weeks
Correct answer: B. Every 2 to 4 months

Explanation

Once ferritin falls below 50 ng/mL, maintenance phlebotomy is required every 2 to 4 months to keep ferritin in the target range of 50 to 100 ng/mL. More frequent phlebotomy risks iron deficiency. Less frequent phlebotomy allows reaccumulation. This schedule is standard in both Indian and international guidelines.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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