DEAR DR. DONOHUE: I have been diagnosed with hemochromatosis. I would like to know the long-term prognosis for this disorder and any preventive measures that I can take. – K.S.

ANSWER: Hemochromatosis (HE-moe-CROW-muh-TOE-siss), an illness with a tongue-twisting and unfamiliar name, is not an unfamiliar disease. People whose ethnic roots lie in Northern European countries have a one in 10 chance of carrying the gene for it. Carriers don’t come down with the illness. It takes two genes to do that – one from the mother and one from the father. There is, however, a large pool of carriers who can marry each other and pass the illness to their children.

A healthy digestive tract allows only the needed amount of iron to pass into the blood. People with hemochromatosis have lost the ability to limit the amount of iron they absorb. Too much gets into the blood, and it settles in organs such as the liver, the pancreas, the heart, joints and skin.

After age 40, the iron-laden organs begin to fail. The liver becomes scarred – cirrhotic – and malfunctions. Pancreatic involvement leads to diabetes, since the pancreas is the site for insulin production. Joints can become arthritic. The heart can fail. The skin often takes on a bronze hue.

All of this is preventable if the condition is discovered early and treated. Treatment consists of periodically removing blood, since red blood cells are the chief repository of body iron.

All you need to do is to follow your doctor’s advice about blood removal. You must avoid alcohol. It accelerates liver damage. Your brothers, sisters, sons and daughters ought to be checked for this illness so their doctors can be on the alert to begin blood removal at the appropriate time.

The Hemochromatosis Foundation, Box 8569, Albany, NY 12208, will provide you with full information on the disorder and its treatment. Please include a SASE. Canadians can obtain information from the Canadian Hemochromatosis Society at 1-877-223-4766.

DEAR DR. DONOHUE: Forty years ago my mother was diagnosed with arthritis. Her health has steadily declined through the years. She was told she has Felty’s syndrome. I understand it goes hand in hand with arthritis. What do you know about this condition? – K.S.

ANSWER: Felty’s syndrome is something that happens to a small number of people with rheumatoid arthritis. Rheumatoid arthritis is the arthritis variety that is a systemic illness; it can affect lungs, heart, eyes and blood vessels in addition to joints. Osteoarthritis is the more common kind of arthritis, and it is limited to joints only. Felty’s syndrome is not associated with it.

With the onset of Felty’s syndrome, a rheumatoid arthritis patient has a drop in the white blood cell count. White blood cells are infection fighters, so one of the consequences of Felty’s syndrome is recurrent infections.

A second aspect of the syndrome is spleen enlargement.

Why Felty’s syndrome appears is an unresolved question.

Treatment includes medicines such as lithium, methotrexate and a newer drug called granulocyte colony-stimulating factor. Sometimes the spleen is removed, and people then have a rise in their white blood count.

DEAR DR. DONOHUE: My dear granddaughter, who is almost 14 years old, is starting to get acne. She eats a lot of chocolate ice cream and drinks chocolate milk. Is chocolate bad for her, and does it make acne worse? – G.C.

ANSWER: At one time, dietary restrictions were an integral part of acne treatment. Chocolate was on the list of banned foods. There has never been proof, however, that it made acne worse.

Your granddaughter can continue her affair with chocolate so long as she doesn’t have an acne outbreak after eating or drinking it.

The only prohibited foods and drinks for people with acne are ones they can identify as making their acne worse. It’s an individual thing.

DEAR DR. DONOHUE: I had a number of blood tests done as a matter of routine. The lab sent me the results. All were marked as normal except for the “hepatitis A antibody.” Does it mean I am sick? I feel good. Should I be taking medicine? – H.J.

ANSWER: Antibodies are bullets that the body’s immune system fires at invading germs. They’re not usually a sign of trouble.

In your case, antibodies to the hepatitis A virus indicate that, at some time in the past, the virus and you had a rendezvous. It’s about the same as having had the hepatitis A vaccine. You should never get an infection with this virus again.

It might not have made you sick at the time. It often does not. Or it might have caused an illness so mild that you fluffed it off as stomach flu.

Don’t take that to mean all hepatitis A infections are nothing. Some are so serious that they require hospitalization.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.


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