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By James Peter Adam Hamilton, MD, Assistant Professor of Medicine, Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine

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Hemosiderosis is focal deposition of iron that does not cause tissue damage.

Focal hemosiderosis can result from hemorrhage within an organ. Iron liberated from extravasated RBCs is deposited within that organ, and significant hemosiderin deposits may eventually develop. Occasionally, iron loss due to tissue hemorrhage causes iron deficiency anemia because iron in tissues cannot be reused.

Usually the lungs are affected, and the cause usually is recurrent pulmonary hemorrhage, either idiopathic (eg, Goodpasture syndrome) or due to chronic pulmonary hypertension (eg, as a result of primary pulmonary hypertension, pulmonary fibrosis, severe mitral stenosis).

Another common site of accumulation is the kidneys, where hemosiderosis can result from extensive intravascular hemolysis. Free Hb is filtered at the glomerulus, resulting in iron deposition in the kidneys. The renal parenchyma is not damaged, but severe hemosiderinuria may result in iron deficiency.