Characteristics of participants with self‐reported hemochromatosis or iron overload at HEIRS study initial screening

• Published in: American journal of hematology 2008-02, Vol.83 (2), p.126-132
• Main Authors: Barton, James C., Acton, Ronald T., Leiendecker‐Foster, Catherine, Lovato, Laura, Adams, Paul C., Eckfeldt, John H., McLaren, Christine E., Reiss, Jacob A., McLaren, Gordon D., Reboussin, David M., Gordeuk, Victor R., Speechley, Mark R., Press, Richard D., Dawkins, Fitzroy W.
• Format: Article
• Language: English
• Subjects: Adult; Antimicrobial Cationic Peptides - genetics; Biological and medical sciences; Female; Genotype; Hematologic and hematopoietic diseases; Hemochromatosis - complications; Hemochromatosis - diagnosis; Hemochromatosis - genetics; Hemochromatosis Protein; Hepcidins; Histocompatibility Antigens Class I - genetics; Homozygote; Humans; Iron Overload - complications; Iron Overload - diagnosis; Iron Overload - genetics; Male; Medical sciences; Membrane Proteins - genetics; Metabolic diseases; Metals (hemochromatosis...); Mutation; Other metabolic disorders; Phenotype; Promoter Regions, Genetic; Receptors, Transferrin - genetics; Sequence Deletion
• ISSN: 0361-8609; 1096-8652
• DOI: 10.1002/ajh.21053

There are few descriptions of young adults with self‐reported hemochromatosis or iron overload (H/IO). We analyzed initial screening data in 7,343 HEmochromatosis and IRon Overload Screening (HEIRS) Study participants ages 25–29 years, including race/ethnicity and health information; transferrin saturation (TS) and ferritin (SF) measurements; and HFE C282Y and H63D genotypes. We used denaturing high‐pressure liquid chromatography and sequencing to detect mutations in HJV, TFR2, HAMP, SLC40A1, and FTL. Fifty‐one participants reported previous H/IO; 23 (45%) reported medical conditions associated with H/IO. Prevalences of reports of arthritis, diabetes, liver disease or liver cancer, heart failure, fertility problems or impotence, and blood relatives with H/IO were significantly greater in participants with previous H/IO reports than in those without. Only 7.8% of the 51 participants with previous H/IO reports had elevated TS; 13.7% had elevated SF. Only one participant had C282Y homozygosity. Three participants aged 25–29 years were heterozygous for potentially deleterious mutations in HFE2, TFR2, and HAMP promoter, respectively. Prevalences of self‐reported conditions, screening iron phenotypes, and C282Y homozygosity were similar in 1,165 participants aged 30 years or greater who reported previous H/IO. We conclude that persons who report previous H/IO diagnoses in screening programs are unlikely to have H/IO phenotypes or genotypes. Previous H/IO reports in some participants could be explained by treatment that induced iron depletion before initial screening, misdiagnosis, or participant misunderstanding of their physician or the initial screening questionnaire. Am. J. Hematol., 2008. © 2007 Wiley‐Liss, Inc.