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Thyroiditis heralding Hereditary Hemochromatosis: an unusual initial manifestation and review of literature

Taha Sheikh, Hira Rehman and Hina Shuja

The systemic involvement that often manifests in genetic hemochromatosis is well known. Although evidence of iron deposition in endocrine glands has been widely reported, the probable functional changes due to disrupted and altered thyroid in the course of hemochromatosis have not been attributed and defined yet. The deposition of iron in the thyroid gland may directly affect it and the functionality of thyroid may be possibly disrupted by the accumulation of iron in the pituitary gland. The prevalence and the pathogenetic links of primary thyroid disease in patients with genetic hemochromatosis are still largely unknown and need to be studied. Hereby, we describe one patient affected by genetic hemochromatosis who developed Hashimoto's thyroiditis. Considering the possible links occurring among iron overload, thyroid gland damage and thyroid dysfunction, we hypothesize that hemochromatosis could have been an important factor for the development of primary thyroid disease in this patient. We conclude that systematic studies in large and heterogeneous populations should be conducted in order to assess the risk of development of primary thyroid disorders in course of genetic hemochromatosis and, more generally, chronic iron overload conditions. It is our opinion thyroid function should be periodically checked in all patients with chronic iron overload conditions.