title: HFE genotyping demonstrates a significant incidence of hemochromatosis in undifferentiated arthritis.
abstract: OBJECTIVE
  Hereditary hemochromatosis is a common autosomal recessive disorder of iron metabolism. Among Northern Europeans the carrier frequency is estimated to be 1 in 10, while up to 1 in 200 is affected by the disease. Arthropathy is one early clinical manifestation of this disease, but the articular features are often misdiagnosed. In this study the two frequent mutations of the HLA-linked hemochromatosis gene (HFE) were investigated in a rheumatology clinic population.
  
  
  METHODS
  Two hundred and six consecutive patients (mean age 57.7 years; 38 male/168 female) attending a rheumatology clinic over a period of 14 months were screened for HFE mutations (C282Y and H63D). All standard diagnostic procedures were used to identify the aetiology of the arthropathy. Mutations were evaluated by separation on PAGE of digested PCR amplificates of DNA (by SnapI and Bcl-I, for C282Y and H63D, respectively) obtained from PBMCs.
  
  
  RESULTS
  The C282Y and H63D allele frequencies were 4.5 and 12.8 in patients with rheumatic diseases. Five patients were homozygote for H63D (2.4%), and one for C282Y (0.5%). Five patients were compound heterozygous (2.4%). The observed C282Y allele frequency in rheumatic patients with undifferentiated arthritis was 12.9 and exceeded that of healthy subjects (p = 0.01).
  
  
  CONCLUSIONS
  Determination of the HFE genotype is clinically useful in patients with arthritis of unknown origin, to allow early diagnosis of hemochromatosis.
authors.affiliation: Department of Internal Medicine V, Department of Rheumatology, Wilhelminenspital, Vienna, Austria. edmund.cauza@wienkav.at
authors.forename: E
authors.initials: E
authors.lastname: Cauza
authors.forename: U
authors.initials: U
authors.lastname: Hanusch-Enserer
authors.forename: M
authors.initials: M
authors.lastname: Etemad
authors.forename: M
authors.initials: M
authors.lastname: Köller
authors.forename: K
authors.initials: K
authors.lastname: Kostner
authors.forename: P
authors.initials: P
authors.lastname: Georg
authors.forename: A
authors.initials: A
authors.lastname: Dunky
authors.forename: P
authors.initials: P
authors.lastname: Ferenci
mesh_terms: D000328:Adult; D001168:Arthritis / Q000209:etiology* / Q000235:genetics*; D015535:Arthritis, Psoriatic / Q000209:etiology / Q000235:genetics; D001172:Arthritis, Rheumatoid / Q000209:etiology / Q000235:genetics; D005260:Female; D005787:Gene Frequency; D005820:Genetic Testing; D005838:Genotype; D006432:Hemochromatosis / Q000150:complications* / Q000175:diagnosis / Q000235:genetics*; D000071020:Hemochromatosis Protein; D015395:Histocompatibility Antigens Class I / Q000235:genetics*; D006801:Humans; D008297:Male; D008565:Membrane Proteins / Q000235:genetics*; D008875:Middle Aged; D020125:Mutation, Missense; D010003:Osteoarthritis / Q000209:etiology / Q000235:genetics
chemical_list: C103673:HFE protein, human; D000071020:Hemochromatosis Protein; D015395:Histocompatibility Antigens Class I; D008565:Membrane Proteins