4.3 Article

Hereditary hemochromatosis: An update vision of the laboratory diagnosis

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ELSEVIER GMBH
DOI: 10.1016/j.jtemb.2023.127194

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Iron overload; Hemochromatosis; Hyperferritinemia

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Haemochromatosis (HC) is an inherited disorder of iron metabolism, mainly caused by mutations in the HFE gene (HC type 1). Genetic studies and analysis of biochemical parameters are important in the diagnosis of HC. Other non-HFE genes can also cause HC. The genotype may not always determine the phenotype expression in this disease.
Haemochromatosis (HC) is an inherited disorder of iron metabolism. The 85-90% of Hereditary hemochroma-tosis cases are caused by mutations in HFE gene (HC type 1). The remaining 10-15% of HC cases are caused by mutations in other non-HFE genes (HJV, HAMP, TRF2, SLC40A1, BMP6). The study of patients for the diagnosis of HC has an important laboratory approached: analysis of biochemical parameters and genetic studies. To confirm a case, it is necessary to carry out a genetic study of the C282Y and H63D mutations. The presence of C282Y mutation in homozygosis is compatible with the diagnosis of HC type 1. Due to the incomplete penetrance of this mutation and the variable phenotypic expression, the severe forms of the disease are relatively rare. The study of variants in non-HFE genes allows more detailed study of both non-classic HC cases and those with more severe clinical expression. The genotype characterization of a patient not always justified the phenotype expression of the symptoms in this disease. All laboratory clinicians must consider recommendation provide by the experts in the Materia.

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