Hereditary haemochromatosis presenting with diabetic ketoacidosis.
Learning points for clinicians

A previously healthy 53-year-old Caucasian man presented to the emergency department with vomiting, lethargy and blurring of vision for five days and polydipsia, polyuria and weight loss of 6 kg over a month. He was dehydrated and deeply tanned (Figure 1A). On direct enquiry he recalled that his father and paternal uncle were also dark and died in their fifties from heart disease. He had no history of blood transfusions, alcohol use or smoking. He had hepatomegaly without stigmata of chronic liver disease, heart failure or endocrine disease. …