Dx of Hemochromatosis

iron sat >45% (iron/TIBC × 100%); ↑ ferritin (acute phase reactant, so poor Sp; often nl in young Pts). If ↑ iron sat. → ✓ HFE to confirm dx, imaging by MRI (black liver). If HFE ⊕ & ferritin >1000 ng/mL or ↑ LFTs → liver bx for quant Fe index & to stage fibrosis