Treatment for hemosiderin focuses on limiting the effects of the underlying disease leading to continued deposition. In hemochromatosis, this entails frequent phlebotomy granulomatosis, immune suppression is required. Limiting blood transfusions and institution of iron chelation therapy when iron overload is detected are important when managing sickle-cell anemia and other chronic hemolytic anemias. The aims of iron chelation therapy include (a) prevention therapy in order to minimize the risk of onset of iron-mediated complications, (b) rescue therapy for the removal of storage iron and (c) emergency therapy if heart failure develops or if there is a downward trend of left ventricular (LV) function that requires hospitalisation using continuous intravenous desferrioxamine (DFO), possibly combined with deferiprone (DFP). It aims to balance the rate of iron accumulation from blood transfusion by increasing iron excretion in urine and in faeces with chelators. There are currently three licensed iron chelators, DFO, DFP and Deferasirox (DFX). The Guide for the Management of Transfusion Dependent Thalassaemia (TDT) issued by the Thalassaemia International Federation (TIF Publication No23, 2017) contains details of dose and regimen adjustment of iron chelation therapy, adherence to therapy and use of combination therapies as well as monitoring of chelation therapy in special circumstances such as pregnancy, renal impairment and summary recommendations.
Hemosiderosis
Hemosiderin hyperpigmentation
Hemosiderin
Iron metallic discoloration
Iron overload
Hemosiderinuria
Iron lung
Venetian ceruse