Stages

Biochemical Parameters and clinical symptoms

Stage 0

No biochemical and clinical abnormalities

Stage 1

Increased TS (>45%), normal serum ferritin
No clinical symptoms

Stage 2

Increased TS, increased serum ferritin (>200µg/L in females and >300 µg/L in males)
No clinical symptoms

Stage 3

Abnormalbiochemical values
Initial clinicalsymptoms (fatigue, arthritis, impotence, skin hyperpigmentation)

Stage 4

Abnormal biochemical values
Clinical symptoms manifesting organ damage (cirrhosis, diabetes, hypogonadism, or cardiomyopathy)

Scale proposed by the Haute Autorité de Santé as clinical recommendations on the HH management [14]
Table 2: Stages in HH.