When should I consider referring a patient with haemochromatosis to a specialist for further evaluation and management?

Consider referring a patient with haemochromatosis to a specialist for further evaluation and management if they have evidence of liver disease, particularly cirrhosis or signs of decompensated liver disease. This includes patients with clinical features such as ascites, encephalopathy, or gastrointestinal bleeding, or those diagnosed with cirrhosis by imaging or transient elastography.

Referral should be to a hepatologist or gastroenterologist with an interest in hepatology. Following specialist assessment, management may be shared with primary care depending on the clinical situation.

Early referral is especially important if there is decompensated liver disease or if the patient is at high risk of complications.