CASE REPORT: Effect of venesection on bone mineral density in an eugonadalwoman with haemochromatosis

Background: A 41-year-old premenopausal woman with newly diagnosed haemochr omatosis was found to have osteopenia on screening bone mineral densitometr y. Methods and Results: Liver biopsy showed grade 3 haemochromatosis with an h epatic iron index of 4. Investigation for secondary factors for osteopenia revealed no cause. The patient was clinically and biochemically eugonadal. Following venesection of 8 L blood (4 g iron) over 17 months and calcium su pplementation, her bone density rose significantly. Neck of femur bone dens ity increased by 6.0% over 13 months and lumbar vertebral bone density incr eased by 7.2%. There are no previous reports of response of bone density to venesection in eugonadal patients or in women with haemochromatosis.