Symptoms and Signs Focal hemosiderosis chiefly occurs in the lungs and kidneys and is the result of other obvious disease processes. Pulmonary hemosiderosis caused by recurrent pulmonary hemorrhage occurs as an idiopathic entity, as part of Goodpasture's syndrome, or in severe mitral stenosis. Occasionally, the Fe loss from these episodes of hemorrhage into the lungs causes Fe-deficiency anemia because Fe cannot be reutilized. Free Hb is filtered at the glomerulus, and renal Fe deposition occurs with saturation of haptoglobin. The renal parenchyma is not damaged, but severe hemosiderinuria may result in Fe deficiency.
Genetic hemochromatosis is uncommonly symptomatic before middle age.
In women, symptoms more commonly develop after menopause because Fe loss during menses and pregnancy provides some protection. Thus, hepatic Fe content is higher in women whose menopause occurs before age 50. Despite blood loss during pregnancy and menses, women have the full phenotypic clinical expression of hemochromatosis. Pituitary failure is common and may be the cause of testicular atrophy and loss of libido, which are frequent. Abdominal pain, arthritis, and chondrocalcinosis occur less often.