Patient-focused outcomes following detection in a hospital-based screening programme for C282Y haemochromatosis.
BACKGROUND
Haemochromatosis is a common genetic disease in populations of a northern European origin. However, there is uncertainty as to whether it is a condition that should be screened for.


OBJECTIVE
To determine the proportion of persons, in a public hospital setting, who were homozygous for the C282Y mutation for hereditary haemochromatosis and the proportion of these persons who would benefit from therapeutic phlebotomy.


METHODS
All persons who had blood submitted for pathology testing, had total iron-binding capacity and iron measured and transferrin saturation calculated, and where this result exceeded 40%, genotyping for the C282Y mutation was carried out.


RESULTS
Of 18,779 patients screened, 887 (5.4%) were found to have transferrin saturation greater than 40%. Thirty-five of these were homozygous for the C282Y mutation. Fourteen were previously known to be affected and six of these were non-compliant with venesection. Venesection was commenced in 5 of the 21 newly diagnosed subjects.


CONCLUSIONS
The proportion of detected subjects who commenced venesection was significant. Results suggest that clinical penetrance is higher in Australia than other countries and that even in the environment of a large tertiary teaching hospital, phenotypic screening identifies cases of hereditary haemochromatosis, which are likely to benefit from treatment.
McCullen
M A
MA
Department of Gastroenterology and Hepatology, Royal Brisbane Hospital, Brisbane, Qld, Australia.
Fletcher
L M
LM
Dimeski
G
G
Pink
A
A
Powell
L W
LW
Crawford
D H G
DH
Hickman
P E
PE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005820:Genetic Testing / Q000379:methods*; D006432:Hemochromatosis / Q000175:diagnosis / Q000235:genetics* / Q000628:therapy*; D000071020:Hemochromatosis Protein; D015395:Histocompatibility Antigens Class I / Q000235:genetics*; D006784:Hospitals, Teaching / Q000379:methods*; D006801:Humans; D008297:Male; D008565:Membrane Proteins / Q000235:genetics*; D008875:Middle Aged; D009154:Mutation / Q000235:genetics; D018802:Patient-Centered Care / Q000379:methods*; D010641:Phenotype; D018962:Phlebotomy / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
C103673:HFE protein, human; D000071020:Hemochromatosis Protein; D015395:Histocompatibility Antigens Class I; D008565:Membrane Proteins