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No HPO annotations are available for this condition.
The clinical manifestations of aceruloplasminemia are retinal degeneration, diabetes mellitus (DM), and neurologic signs/symptoms . Individuals with aceruloplasminemia often present with iron-restricted microcytic anemia prior to onset of DM or neurologic signs/symptoms. Phenotypic expression varies even within families. A summary of clinical manifestations and age of onset in 71 Japanese individuals is shown in . The manifestations (in order of frequency) are anemia, retinal degeneration, diabetes mellitus, and neurologic signs/symptoms. The neurologic signs/symptoms correspond to regions of brain iron accumulation and include ataxia, involuntary movement, parkinsonism, and cognitive dysfunction .
Aceruloplasminemia is characterized by iron accumulation in the brain and viscera.
Aceruloplasminemia should be suspected in individuals with characteristic MRI findings, more than one of the following clinical findings, and typical results on laboratory testing. MRI. Abnormal low intensities in the liver as well as the striatum, thalamus, and dentate nucleus of the brain on T1- and T2-weighted images are consistent with iron deposition and support a diagnosis of aceruloplasminemia .
Clinical findings
No approved treatments are currently available for disorder of iron metabolism and transport. The disease remains an area of unmet medical need.
To establish the extent of disease and needs in an individual diagnosed with aceruloplasminemia, the evaluations summarized in this section (if not performed as part of the evaluation that led to the diagnosis) are recommended:
Marked accumulation of iron in parenchymal tissues including the liver, pancreas, heart, and thyroid can result in diabetes mellitus, cardiac failure, and hypothyroidism.
All affected individuals should have an annual glucose tolerance test starting at age 15 years to evaluate for the onset of diabetes mellitus.
Cardiac evaluation should be performed early in the course of the disease and repeated every year.
No clinical trials have been registered for disorder of iron metabolism and transport.
211 publications have been identified in PubMed for disorder of iron metabolism and transport. Research spans Basic Science / Preclinical (63%), Review / Meta-Analysis (24%), and Epidemiology / Natural History (5%).
Research Type | Count | % of Total |
|---|---|---|
Laboratory research | 130 | 63% |
Data assembled from 4 of 12 sources · Last updated Sep 20, 2026, 5:41 PM UTC
European rare disease database
Genetic and Rare Diseases Info Center
Table 2.
Clinical Manifestations / Age at Onset in 71 Individuals with Aceruloplasminemia
Source: GeneReviews — "Aceruloplasminemia"
Table 4.
Disorders to Consider in the Differential Diagnosis of Aceruloplasminemia
Disorder | Gene(s) | MOI | Clinical Features
Overlapping | Distinguishing (in aceruloplasminemia)
NBIA with later onset1
Atypical pantothenate kinase-associated neurodegeneration (PKAN) | PANK2 | AR | Radiographic evidence of focal iron accumulation in brain, usually basal ganglia | • Iron accumulation in several visceral organs as well as brain
Development of diabetes retinopathy
| FTL | AD
Copper metabolic disorder
Wilson disease2,3 | ATP7B | AR | Ceruloplasmin deficiency | • Radiographic evidence of iron accumulation in basal ganglia, especially thalamus
Iron accumulation in several visceral organs as well as brain
Iron metabolic disorder
Source: GeneReviews — "Aceruloplasminemia"
Biomarker and diagnostic research for disorder of iron metabolism and transport has been reported in the published literature.
Neurologic findings. Brain MRI
Diabetes mellitus. Glucose tolerance test; blood concentrations of insulin and HbA1c
Retinal degeneration. Examination of the optic fundi and fluorescein angiography
Anemia. Complete blood count
Other. Consultation with a clinical geneticist and/or genetic counselor
Note: Individual case reports indicate the effectiveness of treatment in individuals with aceruloplasminemia; however, no large series of symptomatic persons treated with iron chelators and zinc is available and there is no universally accepted treatment regimen. A systematic review/analysis of studies designed to evaluate the clinical effectiveness of desferrioxamine, deferiprone, deferasirox, and zinc as monotherapy for the initial treatment of various clinical presentations of aceruloplasminemia is needed. Desferrioxamine. Treatment with iron chelating agents (i.e., desferrioxamine) can be considered for symptomatic individuals whose blood hemoglobin concentration is higher than 9 g/dL.
Source: GeneReviews — "Aceruloplasminemia"
Iron supplements. Individuals with aceruloplasminemia erroneously diagnosed as having iron deficiency anemia and treated with iron supplements had accelerated iron accumulation.
Source: GeneReviews — "Aceruloplasminemia"
Search ClinicalTrials.gov in the US and EU Clinical Trials Register in Europe for information on clinical studies for a wide range of diseases and conditions.
Source: GeneReviews — "Aceruloplasminemia"
View trials for disorder of iron metabolism and transport
Evaluation of thyroid and liver function and complete blood count are indicated annually starting at the time of diagnosis.
Source: GeneReviews — "Aceruloplasminemia"
Research summaries
50 |
24% |
Disease patterns and progression | 11 | 5% |
New treatment approaches | 9 | 4% |
Clinical study results | 4 | 2% |
Testing and diagnosis research | 2 | 1% |
Other research | 1 | 0% |
Patient case studies | 1 | 0% |
Li X (2026). [PMID: 41721865](https://pubmed.ncbi.nlm.nih.gov/41721865/). *Neurochem Res*. [Basic Science / Preclinical]
Liu Z (2026). [PMID: 41507665](https://pubmed.ncbi.nlm.nih.gov/41507665/). *Nat Metab*. [Basic Science / Preclinical]
Cheng M (2026). [PMID: 42094831](https://pubmed.ncbi.nlm.nih.gov/42094831/). *Front Psychiatry*. [Review / Meta-Analysis]
Van Mulders A (2026). [PMID: 41698932](https://pubmed.ncbi.nlm.nih.gov/41698932/). *Nat Commun*. [Basic Science / Preclinical]
Zhao L (2026). [PMID: 41317841](https://pubmed.ncbi.nlm.nih.gov/41317841/). *J Mol Cell Cardiol*. [Basic Science / Preclinical]
Bucarey JL (2026). [PMID: 41828457](https://pubmed.ncbi.nlm.nih.gov/41828457/). *Int J Mol Sci*. [Review / Meta-Analysis]
Cirovic A (2026). [PMID: 41235980](https://pubmed.ncbi.nlm.nih.gov/41235980/). *J Steroid Biochem Mol Biol*. [Review / Meta-Analysis]
Chrayteh D (2026). [PMID: 41171231](https://pubmed.ncbi.nlm.nih.gov/41171231/). *The Journal of investigative dermatology*. [Review / Meta-Analysis]
Wang Q (2026). [PMID: 41515255](https://pubmed.ncbi.nlm.nih.gov/41515255/). *Nutrients*. [Basic Science / Preclinical]
Freitas SML (2026). [PMID: 40788703](https://pubmed.ncbi.nlm.nih.gov/40788703/). *Critical reviews in food science and nutrition*. [Review / Meta-Analysis]