Iron overload among African Americans attributable to excessive iron absorption has been described infrequently. Recent observations that allow further characterization of this syndrome are described herein. By definition, the serum ferritin concentration is elevated in untreated subjects. However, the serum iron concentration and transferrin saturation values are sometimes normal, particularly when iron overload is mild. Among patients with more severe iron loading, these latter values are often but not invariably elevated.
Indirect evidence suggests that African American iron overload is common.
Among subjects from the general African American population 45 years of age in a large nutritional survey, hyperferritinemia consistent with iron overload was more common among African Americans than Caucasians, and some of these African Americans had iron overload proven by standard clinical methods. African American iron overload sometimes occurs in siblings, in successive generations, and in close relatives, suggesting that a genetic factor may contribute to this disorder. Therefore, it seems likely that the inherited factor associated with this disorder is also common among African Americans. Chronic viral hepatitis C and excess ethanol ingestion are also common, and probably contribute to the hepatic pathology in some patients. Arthropathy, diabetes mellitus, and hypogonadotrophic hypogonadism are common, but cardiac abnormalities are infrequent.