The clinical relevance of compound heterozygosity for the C282Y and H63D substitutions in hemochromatosis.

The clinical relevance of compound heterozygosity for the C282Y and H63D substitutions in hemochromatosis. Research Abstract Details 

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The clinical relevance of compound heterozygosity for the C282Y and H63D substitutions in hemochromatosis. Abstract Text:

Alissa Walsh,Jeannette L Dixon,Grant A Ramm,David G Hewett,Douglas J Lincoln,Gregory J Anderson,V Nathan Subramaniam,Julian Dodemaide,Juleen A Cavanaugh,Mark L Bassett,Lawrie W Powell,

BACKGROUND & AIMS: Two major mutations are defined within the hemochromatosis gene, HFE. Although the effects of the C282Y substitution have been well characterized, the clinical significance of the C282Y/H63D state remains unclear. This study assessed the phenotypic expression in C282Y/H63D subjects as compared with C282Y homozygotes. METHODS: Data were obtained from 91 C282Y/H63D probands, 158 C282Y/H63D subjects identified through family screening, and 483 C282Y homozygotes. Subjects underwent clinical evaluation, genotyping, biochemical assessment, and liver biopsy examination where clinically indicated. RESULTS: C282Y/H63D probands had significantly less clinical and biochemical expression than C282Y homozygotes. Biochemical expression was higher in C282Y/H63D probands than in C282Y/H63D subjects identified through family screening (P < .001). Of the C282Y/H63D subjects with serum ferritin levels greater than 1000 mug/L, all had known comorbid factors that could have contributed to the increased ferritin level. Of the 51 C282Y/H63D subjects who underwent liver biopsy examination, significantly increased iron stores were present in 9 subjects and hepatic fibrosis was present in 13. Twelve of the 13 had evidence of hepatic steatosis, excess alcohol consumption, or diabetes. The mobilizable iron level was significantly higher in C282Y homozygous males than in compound heterozygous males (P < .001). Genetic screening of C282Y/H63D first-degree relatives detected 5 C282Y homozygotes. CONCLUSIONS: C282Y/H63D subjects referred for assessment had a high prevalence of increased iron indices but did not develop progressive clinical disease without comorbid factors such as steatosis, diabetes, or excess alcohol consumption. When fibrosis was seen, 1 or more comorbid factors almost always were present. Thus, phlebotomy therapy is warranted and cascade screening of relatives should be performed because expressing C282Y homozygotes may be detected.

The clinical relevance of compound heterozygosity for the C282Y and H63D substitutions in hemochromatosis. Publishing Authors By Initials

A Walsh,JL Dixon,GA Ramm,DG Hewett,DJ Lincoln,GJ Anderson,VN Subramaniam,J Dodemaide,JA Cavanaugh,ML Bassett,LW Powell,

For similar genetic phenomena: phenotype research abstracts see: genetic phenomena: phenotype research

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The clinical relevance of compound heterozygosity for the C282Y and H63D substitutions in hemochromatosis. Journal Published:

PUBLICATION TYPE: Research Support, Non-U.S. Gov

Journal: Clinical gastroenterology and hepatology : the off

VOLUME: 4

Page Numbers: 1403-10

Journal Abbreviation: Clin. Gastroenterol. Hepatol.

ISSN: 1542-3565

DAY: 18

MONTH: 09

YEAR: 2006

The clinical relevance of compound heterozygosity for the C282Y and H63D substitutions in hemochromatosis. Information

Number of References:

LANGUAGE: eng

NlmUniqueID: 101160775

The clinical relevance of compound heterozygosity for the C282Y and H63D substitutions in hemochromatosis. Keywords Mesh Terms:

KEYWORDS: Phenotype

MESH TERMS: genetics

Chemical & Substance for Abstract: The clinical relevance of compound heterozygosity for the C282Y and H63D substitutions in hemochromatosis. Information

Substance Name: Ferritins

Registry Number: 9007-73-2

Grant and Affiliation Information for The clinical relevance of compound heterozygosity for the C282Y and H63D substitutions in hemochromatosis.

AFFILIATION: The Department of Gastroenterology & Hepatology, Royal Brisbane & Women's Hospital, Brisbane, Australia.

Country: United States

AGENCY: United States NIDDK

GRANT: 5R01DK057648-04

ACRONYM: DK

MEDLINETA: Clin Gastroenterol Hepatol

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