Hepatitis B-Associated Symptomatic Iron Overload, with Complete Resolution after Nucleoside Analogue Treatment

Symptomatic iron overload and hyperferritinemia are rarely mentioned as complications of chronic hepatitis B infection. We report a case of a 70-year-old woman who presented with symptoms of iron overload including aches in the calves, fatigue, poor appetite, and low mood. Laboratory results showed a serum ferritin of 2449 μg/L and transferrin saturation of 74%. Her symptoms completely resolved with hepatitis B antiviral treatment. Serum ferritin and transferrin saturation also normalized. Symptomatic iron overload is a rare yet clinically important complication that can result from chronic hepatitis B infection.