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18 - Iron overload in Native Africans and African-Americans

Published online by Cambridge University Press:  01 June 2011

James C. Barton ,
Corwin Q. Edwards ,
Pradyumna D. Phatak ,
Robert S. Britton  and
Bruce R. Bacon
By
James C. Barton ,
Corwin Q. Edwards ,
Pradyumna D. Phatak ,
Robert S. Britton  and
Bruce R. Bacon
James C. Barton
Affiliation:
University of Alabama, Birmingham
Corwin Q. Edwards
Affiliation:
University of Utah Medical Center
Pradyumna D. Phatak
Affiliation:
University of Rochester Medical Center, New York
Robert S. Britton
Affiliation:
St Louis University, Missouri
Bruce R. Bacon
Affiliation:
St Louis University, Missouri
James C. Barton
Affiliation:
University of Alabama, Birmingham
Corwin Q. Edwards
Affiliation:
University of Utah School of Medicine, Salt Lake City
Pradyumna D. Phatak
Affiliation:
University of Rochester Medical Center, New York
Robert S. Britton
Affiliation:
St Louis University, Missouri
Bruce R. Bacon
Affiliation:
St Louis University, Missouri
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Summary

African iron overload

African iron overload occurs in 14%–18% of Bantu-speaking Natives in at least 15 countries in sub-Saharan Africa. This type of non-transfusion iron overload is due primarily to the ingestion of large quantities of iron contained in traditional beer, although unconfirmed evidence suggests that there is an African iron overload gene (Table 18.1).

History

Iron overload in native sub-Saharan Africans was first described by Strachan in his 1929 thesis on tuberculosis. The disorder was originally attributed to infections, to poisoning due to copper, tin, or zinc, or to malnutrition. In 1953, it was hypothesized that the intake of excessive quantities of iron leached from iron vessels used for food preparation could account for “Bantu siderosis.” In 1992, the etiology of African iron overload as a purely dietary disorder was contested with the demonstration that heritable factors may influence the development of this condition.

Clinical description

Patients with early iron overload identified during family or other group testing have no symptoms or signs attributable to iron overload. Symptoms usually do not occur until iron overload is severe; they may develop by late adolescence. Iron overload is progressive in most patients. Weakness and fatigue, abdominal discomfort or pain, or low back or hip pain are common presenting complaints. Iron overload occurs with greater frequency and severity among men than in women. Physical examination in subjects with severe iron overload may reveal hyperpigmentation, hepatomegaly, kyphosis, or femoral neck fracture.

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Information
Handbook of Iron Overload Disorders , pp. 211 - 221
Publisher: Cambridge University Press
Print publication year: 2010

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