HH DNA related topics, HFE testing,
results, carriers, etc.
Click on the titles to get to the abstracts/articles, etc..
***Located at the bottom of the page are links to articles on HH
withOUT the known HFE mutations as well as genetic discrimination issues.
Click
here for a list of labs that offer DNA testing by PCR for adults/children
for hereditary hemochromatosis.
[U.S. & Canada only are listed here]
-
A previously undescribed nonsense mutation of the HFE
gene. Clin Genet 2002
Jan 61:40-42. Beutler E, Griffin M, Gelbart T, and West C The Scripps
Research Institute, Department of Molecular and Experimental Medicine,
Division of Hematology, La Jolla, CA, USA; Maine General Medical Center,
Waterville ME, USA. A patient with clinically manifest hereditary
hemochromatosis was found to be heterozygous for the c.845 A-->G (C282Y)
mutation. As simple heterozygotes for this mutation do not develop the
hemochromatosis phenotype, the coding region of the patient's HFE gene was
sequenced and a previously undescribed nonsense mutation was identified at
c.211 C-->T (R74X).
-
Arthropathy
in hereditary hemochromatosis
Curr Opin Rheumatol 2001 Jan; Arthropathy
is one of the leading clinical manifestations of hereditary hemochromatosis (HH).
Although cirrhosis of the liver is crucial for mortality in patients with HH,
arthropathy has the greatest impact on the quality of life
-
Asymptomatic
hemochromatosis subjects: genotypic and phenotypic profiles
Blood, 1 December 2000, Vol. 96, No. 12, pp. 3707-3711; Ronald L.
Sham,
Richard F. Raubertas,
Caroline Braggins,
Joseph Cappuccio,
Margaret Gallagher, and
Pradyumna D. Phatak; From the Department of Medicine, Rochester General
Hospital, the Mary M. Gooley Hemophilia Center Inc, and The University of
Rochester School of Medicine and Dentistry, Rochester, NY; and The Centers for
Disease Control and Prevention, Atlanta GA. Our study demonstrates that TS
screening will identify many individuals with only modest degrees of iron
loading who may not meet traditional phenotypic diagnostic criteria
but who have genotypes associated with iron loading. Those with lower
degrees of iron overload are less likely to be C282Y homozygotes.
-
Biochemical and Genetic Markers of Iron Status and the Risk of Coronary
Artery Disease: An Angiography-based Study.
Clin Chem 2002 Apr;48(4):622-8 Bozzini C, Girelli
D, Tinazzi E, Olivieri O, Stranieri C, Bassi A, Trabetti E, Faccini G,
Pignatti PF, Corrocher R. Department of Clinical and
Experimental Medicine, Department of Mother and Child, Biology and Genetics,
and. the Institute of Clinical Chemistry, University of Verona, 37134 Verona,
Italy. CONCLUSIONS: Our results do not support a role for
biochemical or genetic markers of iron stores as predictors of the risk of CAD
or its thrombotic complications.
-
Clinical
aspects of hemochromatosis. Transfus Sci. 2000 Dec Brissot P,
Guyader D, Loreal O, Laine F, Guillygomarc'h A, Moirand R, Deugnier Y. The
diagnosis can, from now on, be ascertained on the sole association of a
plasma transferrin saturation (TS) over 45% and homozygosity for the C282Y
mutation. Liver biopsy is only required to search for cirrhosis whenever
there is hepatomegaly and/or serum ferritin >1000 ng/ml and/or elevated
serum AST.
-
Clinical
Consequences of New Insights in the Pathophysiology of Disorders of Iron and
Heme Metabolism Hematology 2000
The American
Society of Hematology The screening strategy could
be based on the assessment of serum transferrin saturation in
adults aged 18 or more. Genetic testing testing for C282Y would be
confined to individuals with transferrin saturation > 45%. This
strategy would then avoid the ethical, logistical, and financial
problems raised by systematic genetic testing as well as the
societal impact of discovering a genetic mutation in asymptomatic
persons without a disease. It is, in fact, essential that major
changes occur in the attitudes towards unexpressed or slightly
expressed HFE homozygosity, especially by insurers and health care
administrators, to avoid any adverse genetic discrimination.
-
Clinical management of iron overload.
Gastroenterol Clin North Am. 1998 Sep HHC is a common
inherited disorder, characterized by iron accumulation in the liver, heart,
pancreas, and other organs. The clinical consequences of systemic iron loading
are diverse and not always improved with iron reduction therapy.
-
Clinical
Studies of Haemochromatosis Queensland
Institute of Medical Research, Hepatocellular Cancer Laboratory,
Professor Lawrie Powell Knowledge of haemochromatosis, its
prevention, the type and severity of symptoms it causes, the availability and
nature of treatment, ability of sufferers to participate in normal activities,
and longevity are relevant issues for community education. Members of an
informed public can mobilise support for the early diagnosis of
haemochromatosis, encourage people to be tested for the disorder and influence
the debate about screening.
-
Co-inheritance
of mutations in the uroporphyrinogen decarboxylase and hemochromatosis genes
accelerates the onset of porphyria cutanea tarda
Homozygosity for the C282Y hemochromatosis mutation was associated
with an earlier onset of skin lesions in both familial and sporadic porphyria
cutanea tarda. J Invest Dermatol 2000 Nov
-
Diagnosis and management of
hemochromatosis
by Dr. Anthony Tavill, Director of the Maurice and
Sadie Friedman Center For Digestive Diseases and Liver Disorders, Mathile
and Morton J. Stone Professor of Digestive Diseases and Liver Disorders at
the Mt. Sinai Medical Center,
Professor of Medicine and Nutrition at Case Wetern Reserve University.
[Excellent & thorough article of diagnosis & treatment. This
is a pdf file]
-
Diagnosis and treatment of genetic hemochromatosis
Rev Prat. 2000 May 1 [Article in French]
Moirand R, Guillygomarc'h A, Brissot P, Deugnier Y. The disease can be
lethal due to liver disease, carcinoma or heart disease, but life expectancy
goes to normal if patients are treated before the occurrence of cirrhosis.
Treatment relies on regular venesections. Familial screening is essential.
-
Differential
HFE allele expression in hemochromatosis heterozygotes
Gastroenterology
2000 Oct We demonstrate the existence of differential allelic expression of the
HFE alleles, suggesting that the (187C > G; H63D) mutation plays a role in
the disease expression in H63D heterozygotes, in particular when associated with
environmental or host factors.
-
Disease-Related
Conditions in Relatives of Patients with Hemochromatosis
Zaneta J. Bulaj, M.D., Richard S. Ajioka, Ph.D., John D. Phillips, Ph.D.,
Bernard A. LaSalle, B.S., Lynn B. Jorde, Ph.D., Linda M. Griffen, B.A.,
Corwin Q. Edwards, M.D., and James P. Kushner, M.D. Volume
343:1529-1535 November 23, 2000 Number 21 In
conclusion, our data emphasize the importance of screening relatives
of persons with hemochromatosis.
-
End-stage
liver disease without hemochromatosis associated with elevated hepatic iron
index.
J Hepatol. 1998 Aug;29 Cotler SJ, Bronner MP, Press RD, Carlson
TH, Perkins JD,
Emond MJ, Kowdley KV. Department of Medicine, University of Washington,
Seattle, USA. (i) Serum transferrin saturation and hepatic iron index lack
specificity for hereditary hemochromatosis in end-stage liver disease. (ii)
Genotyping for Cys 282 Tyr may provide the best method to identify hereditary
hemochromatosis in the setting of end-stage liver disease.
- Evaluation
and interpretation of iron in the liver Semin Diagn Pathol
1998 Nov Because homozygosity for the C282Y mutation is diagnostic of the
condition regardless of the liver iron concentration-to-age ratio, indication
for liver biopsy in C282Y homozygotes is restricted to the assessment of
prognostic lesions, such as fibrosis and iron-free-foci.
- Genetic Alliance
Inc.
The Genetic Alliance is an
international coalition representing more than 300 consumer and health
professional organizations with millions of members--all working together to
promote healthy lives for everyone impacted by genetics.
-
Genetic Haemochromatosis: A guideline on Diagnosis & Therapy
compiled on behalf of the Clinical Task Force of the British Committee
for Standards in Haemotology 2/2000 [a pdf file]
-
Haemochromatosis and HFE gene. Acta
Gastroenterol Belg. 1999 Oct-Dec The practical
management of haemochromatosis has been greatly modified, since liver biopsy
is no more necessary for diagnosis in C282Y homozygotes, and is only needed
for exclusion of cirrhosis. Family screening has also greatly benefited from
genotyping.
-
Haemochromatosis:
iron still matters.
Intern Med J 2001 May-Jun Our ability to detect those predisposed to
haemochromatosis is greatly enhanced by testing for HFE mutations. Although the
precise definition of iron overload is debated, a diagnosis of haemochromatosis
cannot be made without demonstrating increased body iron stores.
- Hemochromatosis can now
be appropriately defined as the presence of two hemochromatosis alleles with or
without organ injury, and with or without the presence of iron overload.
[I
have not been able to retrieve the url to the website from where this came, so
if anyone locates it, please let me know!]
-
Hemochromatosis
Powell LW, Yapp TR Clin Liver Dis 2000 Feb: It is now
apparent that iron, even in the modest tissue concentrations, can act as a
co-factor in potentiating cell injury in other liver diseases.
- Hemochromatosis, A simple genetic trait,
Dr. Richard D. Press, Oregon Health Sciences University With the discovery of
the causative gene, the disorder stands revealed as America's single most common
mendelian disease. Unlike other genetic diseases, it is already curable. Indeed,
genetic screening makes it potentially preventable.
-
Hemochromatosis: Conemaugh Health System
Hemochromatosis is a condition that develops when too much iron builds up in
the body. Excess iron is stored in the organs, such as the kidneys, liver, and
heart, and in the joint tissues.
-
Hemochromatosis,
Cooley Dickinson Hospital
Editor: George R Bowers MD
CDH Oncology January
2000 Volume 4: No. 1.
Hemochromatosis is a common, genetically transmitted disease. The
diagnosis of hemochromatosis is sometimes difficult and frequently missed.
This issue will review the pathogenesis, diagnosis and treatment of this
fascinating disease. Ms. Kathy Fleming will review the management of a most
troubling complication of therapy---lymphedema.
-
Hemochromatosis:
diagnosis and management. Bacon BR.Gastroenterology 2001
Feb HFE mutation analysis has strengthened our ability to diagnose HH
accurately and is useful in family studies. HFE mutations may play a
contributory role in some patients with PCT, NASH, or chronic HCV.
-
Hemochromatosis
in Ireland and HFE. Blood Cells Mol Dis. 1998 The allele
frequency of 14% for the C282Y mutation in our control population is the
highest reported and supports the hypothesis of a Celtic origin for the
hereditary hemochromatosis gene.[pdf file]
-
Hemochromatosis: Life Extension Foundation website.
Disease, Prevention & Treatment 3rd editon. Dietary & Vitamin
recommendations listed here including calcium for blocking of iron absorption.
-
Hemochromatosis
Special American Liver Foundation newsletter, ALF
Progress, Vol. 21 No. 1, Summer 1999 The ALF newsletter created three
scenarios based on the real life ethical, economic and medical quandaries
posed by hemochromatosis, and asked three experts from divergent fields to
respond with their opinions. The experts are: Bruce R. Bacon, MD [Director,
Div. of Gastroenterology & Hepatology, Saint Louis University School of
Medicine, St. Louis, M0]; medical ethicist Mark A. Rothstein, Esq.
[Director, University of Houston Law Center, Health Law & Policy
Institute, Houston, TX] and hemachromatosis patient Gayle Hoffman.
-
Hepatitis C, Iron, and Hemochromatosis Gene Mutations A Meaningful
Relationship or Simple Cohabitation?
Dale C. Snover, MD
From the Departments of Pathology, Fairview
Southdale Hospital, Edina, MN, and the University of Minnesota Medical School,
Minneapolis, MN. It would seem prudent to
routinely perform iron stains for all patients with hepatitis C (a practice
currently done in many laboratories on all liver biopsy specimens to rule out
hemochromatosis) and to report iron by location of deposition (portal tract,
hepatocyte, Kupffer cell) and by intensity.
-
Hereditary
Hemochromatosis--A Risk Factor for Cardiovascular Disease
The
HH mutation is a human genetic model of disturbed iron metabolism, which
facilitates research to the mechanism of HH and iron involved in
cardiovascular disease. We expect that in the near future, the mechanism of
disturbed iron metabolism leading to cardiovascular disease in human will be
better understood.
-
Hereditary
Hemochromatosis
CME Activity, Release Date: 2/28/2000 Expiration Date: 2/28/2002 From the
February 2000 Issue of Physician Assistant Objectives: After
reading the article, the reader should be able to:
1. describe the pathophysiology of hereditary hemochromatosis;
2. recognize the clinical symptoms and signs of hereditary
hemochromatosis;
3. outline screening and evaluation testing; and
4. provide accurate diagnosis, management, and treatment.
-
Hereditary Hemochromatosis FamilyPractice.com
Robert B. Hash, MD,
Department of Family Medicine, Mercer University School of Medicine, Macon,
Ga. [J Am Board Fam Pract Dec. 2000]
Considering the prevalence
of the disease, it is important for physicians to consider it in the
differential diagnosis when patients complain of the common signs and
symptoms. For most patients hereditary hemochromatosis can be successfully
treated in the physician's office. Early diagnosis and treatment, before signs
of iron toxicity, if possible, can result in improved quality and quantity of
life for many patients.
-
Hereditary hemochromatosis. J Fam Pract. 1997
Mar Hereditary hemochromatosis is a genetic disorder of
iron metabolism that has an excellent prognosis if diagnosed early.
-
Hereditary
hemochromatosis Rev Med Interne 2000 Nov At present, any patient
admitted with an isolated case of asthenia, or with arthralgia or
hypertransaminasemia should be examined via transferrin-saturation testing: if
the transferrin saturation coefficient is > 45%, then the presence of the
C282Y mutation should be investigated to confirm the diagnosis of
hemochromatosis. A liver biopsy is no longer necessary to establish the
diagnosis.
-
Heterogeneity
of hemochromatosis in Italy
The frequency of C282Y homozygotes was
64%, with a decreasing gradient from north to south. C282Y homozygotes showed
more severe iron overload than the other HFE genotypes. Gastroenterology 1998
May.
-
HFE gene knockout
produces mouse model of hereditary hemochromatosis
Proc Natl Acad Sci U S A. 1998 Mar.
Xiao Yan Zhou, Shunji
Tomatsu, Robert E. Fleming, Seppo Parkkila, Abdul Waheed,
Jinxing Jiang, Ying Fei, Elizabeth M. Brunt, David A.
Ruddy, Cynthia E. Prass, Randall C. Schatzman, Rosemary
O'Neill, Robert S. Britton, Bruce R. Bacon, and William
S. Sly The knockout mouse model of HH
will facilitate investigation into the pathogenesis of increased iron
accumulation in HH and provide opportunities to evaluate therapeutic
strategies for prevention or correction of iron overload.
-
HFE genotype in patients with hemochromatosis and other liver diseases.
Ann Intern Med. 1999 Jun 15 Bacon
BR, Olynyk JK, Brunt EM, Britton RS, Wolff RK. All 66 patients
homozygous for the C282Y mutation of HFE had an elevated hepatic iron
concentration, but approximately 15% of these patients did not meet a previous
diagnostic criterion for hemochromatosis (hepatic iron index > 1.9 mmol/kg per
year). Determination of HFE genotype is clinically useful in patients with
liver disease and suspected iron overload and may lead to identification of
otherwise unsuspected C282Y homozygotes.
- HFE mutations in insulin resistance-associated hepatic
iron overload.J Hepatol. 2000
Sep;33;33(3):515-6. No abstract available.
- High frequency of the H63D mutation of the hemochromatosis gene (HFE) in
malignant gliomas. Neurology 2001 Oct 9 No abstract available but if anyone gets access
to the article, I would like to see it!
-
Histological evaluation of iron in liver biopsies: relationship to HFE
mutations. Am J Gastroenterol. 2000 Jul
Brunt EM, Olynyk JK, Britton RS, Janney CG, Di Bisceglie
AM, Bacon BR. The use of histological evaluation for iron deposition is
simple, assists in expanding information communicated from histopathologic
observations, and may be clinically useful in determining the necessity of
further evaluation of HFE genotype in subjects with histological evidence of
hepatic iron overload.
-
Human
Genetic Diseases E. Beutler, D. Balicki, L. Forman, T. Gelbart, C.
Halloran, E. Boas, P. Lee, C. West Division of Hematology About
82% of U.S. patients with hereditary hemochromatosis are homozygous for the
845A mutation of the gene HFE. HFE, the product of this gene, is a
class 1 MHC protein, and its role in regulating iron absorption is unknown.
We are attempting to answer a number of important but difficult questions
about HFE.
-
Intestinal expression of genes involved in iron absorption in humans. Am
J Physiol Gastrointest Liver Physiol 2002 Apr;282(4):G598-607
Rolfs A, Bonkovsky HL, Kohlroser JG, McNeal K, Sharma A, Berger UV, Hediger
MA. Membrane Biology Program and Renal Division,
Brigham and Women's Hospital, Harvard Medical School, Boston, 02115,
Massachusetts. The lack of appropriate downregulation of apical
and basolateral iron transporters in duodenum likely leads to excessive iron
absorption in persons with HHC.
-
'Iron'
Gene Mutation Increases Heart Attack Risk
Full Health Nutrition Canada ArterialHealth e-News© December
1999 [located about halfway down the page] Carriers almost universally don't
know that they are at increased risk... They have almost no increase in iron
stores, but that small increase is significant and that small increase is
probably what caused the increased incidence of heart disease deaths.
-
Iron in the era of molecular biology Pathol
Biol (Paris). 1999 Nov Identification of the HFE gene
and its C282Y and H63D mutations has improved the classification of iron
overload disorders
- Iron
Overload (Hemosiderosis; Hemochromatosis)
The Merck Manual of
Diagnosis and Therapy Section 11. Hematology And Oncology Chapter 128.
Hemochromatosis is often diagnosed late in the course of disease after
significant tissue injury is present because the clinical symptoms are
insidious and the extent of organ involvement varies; thus, the full
clinical picture evolves slowly
-
Kimball
Genetics
Hemochromatosis DNA- PCR analysis
for both the Cys282Tyr and the His63Asp mutations
-
Making
a Difference in Genetic Disease Endeavor VOLUME
ONE NUMBER TWO Ernest Buetler M.D. It will be the largest such
screening study ever undertaken. The NIH and the CDC have provided funding
of more than $4,000,000 for these clinical studies and the basic studies of
iron metabolism that will be performed in the Beutler laboratory.
-
Molecular
genetics of hemochromatosis Ann Endocrinol (Paris) 1999 Sep Hemochromatosis is a recessive disorder of iron
metabolism characterized by progressive iron loading of parenchymal organs,
which accounts for clinical complications such as cirrhosis, diabetes mellitus,
cardiopathy, endocrine dysfunctions and arthropathy.
-
Mutations
in the hfe gene and their interaction with exogenous risk factors in
hepatocellular carcinoma: Blood Cells Mol Dis 2001 Mar-Apr; These data indicate that the prevalence of the main mutation associated
with hereditary hemochromatosis is significantly higher in cirrhotic Italian
patients with hepatocellular carcinoma compared to a normal population and
suggest that heterozygotes for HFE mutations exposed to hepatitis virus
infections or who had been alcohol abusers could have an increased risk of
developing cirrhosis and later liver cancer than people without the mutations
exposed to the same risk factors.
-
Overview
on Iron Overload and Hemochromatosis
CDC website, National
Center for Chronic Disease Prevention and Health Promotion. Early
detection of hemochromatosis is essential because the disease’s
potentially serious complications can be prevented by early therapy.
-
Patents increasing costs
of blood test, researchers say
At issue are patents on the most common genetic mutations
linked to hereditary hemachromatosis or iron overload, a surprisingly common
and easily treatable disorder that can cause fatal damage to the heart and
liver. Newspaper article from The Mercury News in San Jose, Calif. quotes
David Snyder of AHS.
-
Polymorphisms in the HFE gene. Hum Hered. 1999
Jan The aim of this study was to search for new
mutations in the HFE gene in 16 such patients. Direct sequencing of exons and
3 introns did not reveal any new mutation but identified a few polymorphisms
-
Recognition and management of hereditary hemochromatosis.
Am Fam Physician 2002 Mar 1 65:853-60 Brandhagen DJ,
Fairbanks VF, and Baldus W Mayo Medical School, Rochester, Minnesota, USA. The
HFE gene test is useful in confirming the diagnosis of hereditary
hemochromatosis, screening adult family members of patients with HFE mutations
and resolving ambiguities concerning iron overload.
- Relating Genomic Research to Patient Care
JAMA 11/2000 Educating health care professionals about the
complexities of the genetics of adult disease (in addition to congenital
illness) is an important goal, and one disease model that is useful for this
purpose involves hemochromatosis.
-
Role of the hemochromatosis gene in prophyria cutanea tarda. Prospective study
of 56 cases
Ann Dermatol Venereol. 2001 May
[Article in French] Compound heterozygous and to a lesser
degree H63D homozygous status explained the highest iron overload in our
patients. This favors clinical expression of porphyria cutanea tarda. This
iron overload due to HFE mutations is a new triggering factor of porphyria
cutanea tarda independent of classical triggering factors: mutation of the
erythrocytic uroporpyrinogen decarbocylase gene, alcohol abuse, hepatitis C,
and drugs.
-
Should all patients with diabetes mellitus be screened for hemochromatosis?
Department of Family Medicine University of California, Los Angeles 924
Westwood Blvd, Suite 650 Los Angeles, CA 90095-1628
West J Med 2002;176:110-114 Enhanced
case finding becomes the first stage in a public health response
when evidence has emerged for an effective early treatment of a
disorder. It means the detection of HHC at the time of early
symptoms, and it allows patients to benefit from early phlebotomy.
The implementation of this approach
would include adding fasting serum transferrin saturation to the
usual workup of patients with newly diagnosed diabetes mellitus,
arthritis, and impotence. The CDC recommends such iron-overload testing
in anyone with possible symptoms of hemochromatosis, which
includes patients with newly diagnosed diabetes mellitus.
-
Should we genetically test everyone for haemochromatosis?
J Med Ethics. 1999 Apr
This paper will identify and discuss key issues regarding
DNA-based population screening for haemochromatosis, and argue that
population-based genetic screening for haemochromatosis should be supported
when a number of contentious issues are addressed.
-
Significance of "minor" genetic mutations in hereditary hemochromatosis: 2
case reports
Ann Ital Med Int. 2000 Jul-Sep These two
cases concord with the present scientific orientation, i.e.: 1) homozygosity
for the major mutation is associated with the phenotypical (clinical) picture
of hemochromatosis, but compound heterozygosity also determines significant
iron metabolism abnormalities; 2) homozygosity for the minor mutation does not
appear to determine important phenotypical abnormalities.
-
The diagnosis of hemochromatosis in the era of the gene
Ann Endocrinol (Paris). 1999 Sep [article in French]
The discovery of the hemochromatosis gene has deeply changed
and simplified the diagnosis of the disease. In a given individual,
establishing the diagnosis relies, from now on, on a simple blood sample
showing the couple: elevated transferrin saturation and homozygous C282Y
mutation (= C282Y +/+). Liver biopsy should only be performed when iron
overload is massive in order to detect cirrhosis (or bridging fibrosis), i.e.
in a prognostic view.
-
The haemochromatosis gene: a co-factor for chronic liver diseases?
J Gastroenterol Hepatol. 1999 Aug
George DK, Powell LW, Losowsky MS Iron loading of mild to
moderate degree due to heterozygosity or homozygosity for the haemochromatosis
genetic mutations acts as a significant hepatotoxin aggravating hepatic damage
from other causes of liver disease.
-
The
Hemochromatosis 845 A and 187 CG Mutations: Prevalence in Non-Caucasian
Populations
Am. J. Hum. Genet.,
62:1403-1407, 1998. Although hemochromatosis is common in Caucasians,
affecting 1/300 individuals of northern European origin, it has not been
recognized in other populations. The present study used PCR and
restriction-enzyme digestion to analyze the frequency of the 845 GA and 187 CG
mutations in HLA-typed samples from non-Caucasian populations, comprising
Australian Aboriginal, Chinese, and Pacific Islanders.
-
The HFE CYS282Tyr polymorphism is associated
with cardiovascular mortality.
Roest M, Schouw Yvd, B. de Valk BD, Marx JJM, Tempelman M, de Groot P, Sixma
J, Banga JD. Presented at the July 1998 meeting of the European Iron
Club. Conclusions: Heterozygosity for HH is associated with increased risk of
cerebrovascular and total cardiovascular mortality, in particular in
combination with hypertension and smoking. Long term exposure to minimal iron
overload may enhance atherosclerosis.
- The S65C
mutation in Spain. Implications for iron overload screening
Hereditary hemochromatosis is related to mutations of the HFE gene. The
role of the S65C mutation of this gene was evaluated in a Spanish
population, consisting of 100 controls and 41 patients who had resulted
positive to screening for iron overload. Only one patient was heterozygous
for the S65C mutation, so the S65C mutation is infrequent in our area.
Nevertheless, it is advisable to search for this mutation in cases with iron
overload and heterozygosity for the C282Y or H63D mutations of the HFE
gene.
- The significance of the 187G (H63D) mutation in hemochromatosis
Am J Hum Genet 1997 Sep. No abstract available.
-
Use
of HFE Mutation Analysis for Hereditary Hemochromatosis:
The
Need for Physician Education in the Translation of Basic Science to Clinical
Practice Manish Kohli, MB, ChB, Steven A. Schichman, MD, PhD, Louis Fink, MD, Clive
S. Zent, MB, BCh, Department of Internal Medicine, Division of
Hematology/Oncology and the Department of Pathology, John L. McClellan Memorial
Veteran's Hospital and University of Arkansas for Medical Sciences, Little Rock.
Southern Medical Journal
-
What's
new in hemochromatosis.
Curr Opin Hematol 2001 Mar
The high correlation of HFE to HHC has caused it to be considered as a candidate
gene for population-based genetic testing for diagnosis and detection of
predisposition to HHC.
-
Will Your Genes Prevent
You From Getting Health Insurance? St. Louis
University News Release October 13, 2000 "People may be reluctant to
take advantage of genetic tests that could save their lives," Dr. Bacon said.
"In hemochromatosis, for example, symptoms usually do not appear until between
40 and 60 years of age. By then, the patient may have already sustained
serious liver damage. Early detection is essential. No one should be afraid to
seek information to make educated choices regarding their health."
-
Screening
for hereditary haemochromatosis should be implemented now.
BMJ 2000;320:183 ( 15 January ) We believe that to benefit
all those at risk there is an ethical imperative to implement screening
for the major mutation causing haemochromatosis now, rather than
wait years for confirmation of what is currently known that at
least half of those with the predisposing genotype will develop some
form of the disease.
Links related to genetic discrimination issues:
-
Hemochromatosis
Special American Liver Foundation newsletter, ALF
Progress, Vol. 21 No. 1, Summer 1999 The ALF newsletter created three
scenarios based on the real life ethical, economic and medical quandaries
posed by hemochromatosis, and asked three experts from divergent fields to
respond with their opinions. The experts are: Bruce R. Bacon, MD [Director,
Div. of Gastroenterology & Hepatology, Saint Louis University School of
Medicine, St. Louis, M0]; medical ethicist Mark A. Rothstein, Esq.
[Director, University of Houston Law Center, Health Law & Policy
Institute, Houston, TX] and hemachromatosis patient Gayle Hoffman.
Click on this link to read about HH. Discussion of a liver
biopsy is also here:
Back
to the "Munnsters" main Hemochromatosis page