title: Proton Pump Inhibitors Reduce the Frequency of Phlebotomy in Patients With Hereditary Hemochromatosis.
abstract: OBJECTIVE
  Patients with hereditary hemochromatosis (HH) need frequent phlebotomies to reduce iron overload. Proton pump inhibitors (PPIs) were reported to reduce the need for phlebotomies in patients homozygous for the C282Y mutation in HFE. We investigated the effects of PPI treatment on numbers of phlebotomies in these patients.
  
  
  METHODS
  We conducted a retrospective study of patients with HH homozygous for the C282Y mutation by using the database and medical records from Atrium Medical Centrum Parkstad in Brunssum, The Netherlands. In a paired group analysis of 12 patients, we compared mean serum levels of ferritin and number of phlebotomies needed each year during the periods of 3 years before and 3 years after the start of PPI therapy. We compared these results with those from a group who received PPIs for at least 2 years (n = 9) and a group who never received PPIs (n = 36).
  
  
  RESULTS
  We found a significant reduction in median number of phlebotomies after patients began taking PPIs vs. before (0.50 vs. 3.17, P < .002). Patients who received PPIs for at least 2 years needed significantly fewer phlebotomies than patients in the paired group before they started taking PPIs (1.25 vs. 3.17, P < .001). The number of phlebotomies in the group who never received PPIs was significantly higher than in the paired group after they started taking PPIs (3.0 vs. 0.5, P < .001).
  
  
  CONCLUSIONS
  On the basis of a retrospective analysis, in patients with HH homozygous for the C282Y mutation in HFE, treatment with PPIs for 2 or more years significantly reduced the number of phlebotomies required to maintain serum levels of ferritin below 100 μg/L.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands. Electronic address: vanaerts@hotmail.com.
authors.forename: René M M
authors.initials: RM
authors.lastname: van Aerts
authors.affiliation: Department of Internal Medicine and Gastroenterology, Atrium Medical Center Parkstad, Heerlen, The Netherlands.
authors.forename: Cees Th B M
authors.initials: CT
authors.lastname: van Deursen
authors.affiliation: Division of Gastroenterology and Hepatology and NUTRIM School for Nutrition, Toxicology and Metabolism Research, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Ger H
authors.initials: GH
authors.lastname: Koek
mesh_terms: D000368:Aged; D005260:Female; D005293:Ferritins / Q000097:blood; D006432:Hemochromatosis / Q000151:congenital* / Q000628:therapy*; D000071020:Hemochromatosis Protein; D015395:Histocompatibility Antigens Class I / Q000235:genetics; D006720:Homozygote; D006801:Humans; D008297:Male; D008565:Membrane Proteins / Q000235:genetics; D008875:Middle Aged; D020125:Mutation, Missense; D009426:Netherlands; D018962:Phlebotomy / Q000379:methods*; D054328:Proton Pump Inhibitors / Q000008:administration & dosage*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: C103673:HFE protein, human; D000071020:Hemochromatosis Protein; D015395:Histocompatibility Antigens Class I; D008565:Membrane Proteins; D054328:Proton Pump Inhibitors; D005293:Ferritins
keywords: Dietary Iron Absorption; Genetic; Heme; Hepcidin; Phlebotomies