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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Hemocromotosis,low Platelet Count And Enlarged Spleen. Got Infected, Slow Healing. Cirrhosis Of Liver?

My mother is 80 years old. She has been diagnosed with hemocromotosis , with iron levels four times the normal amount. She also has been told she has a low platelet count and an enlarged spleen . With the exception of chronic arthritis and numerous joint replacements, she has been in fairly good health for most of her life. Last year, she obtained an infection from a joint replacement surgery and was on a wound vac for 6 months. She bruises very easily and heals very slowly. Very low energy levels, but again, she is 80 years old. Is there a chance of cirrhosis of the liver? If so, what can be done? If not, what should we do? She has been told she needs to donate blood. Thank you for your help.
Mon, 18 Mar 2013
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General & Family Physician 's  Response
hi,

Hemochromotosis is a disease mostly defined as iron overload with a hereditary/primary cause or originating from a metabolic disorder or multiple blood transfusion.
1) For the first question about cirrhosis - Answer is yes she will have high chances for cirrhosis of liver
2) For the second question about what could be done - answer is reduce the amount of iron in blood- by blood donation/ by using chelating agents which help to change the iron in different compound.

Now let me evaluate the condition of your mother.
a)her age is 80 yrs
b)She already has low platelets and enlarged spleen.
c) chronic arthritis (probably due to excess of iron deposition).
d) issues with bruising and slow healing.

Now about the therapy option
1) blood donating - chances of prolonged bleeding, infection at sight of donation, already low platelets
2) chelating therapy - (Serious and potentially fatal side effects, which are very rare, include heart failure; a sudden drop in blood pressure; abnormally low blood levels of calcium; permanent kidney damage; and bone marrow depression )

advice:
looking at her age and benefit to risk ratio for medication seem reasonably tending more toward risk side,
my opinion is to let nature take its course as our intervention will probably cause more harm the benefit as well as even we will try to increase her life span , the quality of remaining life will not be as good as if nature will take course and had little bit short life span, may be by 6months or so!!


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Have Hemocromotosis,low Platelet Count And Enlarged Spleen. Got Infected, Slow Healing. Cirrhosis Of Liver?

hi, Hemochromotosis is a disease mostly defined as iron overload with a hereditary/primary cause or originating from a metabolic disorder or multiple blood transfusion. 1) For the first question about cirrhosis - Answer is yes she will have high chances for cirrhosis of liver 2) For the second question about what could be done - answer is reduce the amount of iron in blood- by blood donation/ by using chelating agents which help to change the iron in different compound. Now let me evaluate the condition of your mother. a)her age is 80 yrs b)She already has low platelets and enlarged spleen. c) chronic arthritis (probably due to excess of iron deposition). d) issues with bruising and slow healing. Now about the therapy option 1) blood donating - chances of prolonged bleeding, infection at sight of donation, already low platelets 2) chelating therapy - (Serious and potentially fatal side effects, which are very rare, include heart failure; a sudden drop in blood pressure; abnormally low blood levels of calcium; permanent kidney damage; and bone marrow depression ) advice: looking at her age and benefit to risk ratio for medication seem reasonably tending more toward risk side, my opinion is to let nature take its course as our intervention will probably cause more harm the benefit as well as even we will try to increase her life span , the quality of remaining life will not be as good as if nature will take course and had little bit short life span, may be by 6months or so!!