Patient-focused outcomes following detection in a hospital-based screening programme for C282Y haemochromatosis

Authors

  • M. A. McCullen,

    1. Departments of 1Gastroenterology and Hepatology, 3Chemical Pathology and 4Immunology, Princess Alexandra Hospital,2University of Queensland and 5Queensland Institute of Medical Research, Brisbane, Queensland, Australia
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      Current address: Department of Gastroenterology and Hepatology, Royal Brisbane Hospital, Brisbane, Qld
  • 1, L. M. Fletcher,

    1. Departments of 1Gastroenterology and Hepatology, 3Chemical Pathology and 4Immunology, Princess Alexandra Hospital,2University of Queensland and 5Queensland Institute of Medical Research, Brisbane, Queensland, Australia
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  • 1,2 G. Dimeski,

    1. Departments of 1Gastroenterology and Hepatology, 3Chemical Pathology and 4Immunology, Princess Alexandra Hospital,2University of Queensland and 5Queensland Institute of Medical Research, Brisbane, Queensland, Australia
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  • 3 A. Pink,

    1. Departments of 1Gastroenterology and Hepatology, 3Chemical Pathology and 4Immunology, Princess Alexandra Hospital,2University of Queensland and 5Queensland Institute of Medical Research, Brisbane, Queensland, Australia
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  • 4 L. W. Powell,

    1. Departments of 1Gastroenterology and Hepatology, 3Chemical Pathology and 4Immunology, Princess Alexandra Hospital,2University of Queensland and 5Queensland Institute of Medical Research, Brisbane, Queensland, Australia
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  • 2,5 D. H. G. Crawford,

    1. Departments of 1Gastroenterology and Hepatology, 3Chemical Pathology and 4Immunology, Princess Alexandra Hospital,2University of Queensland and 5Queensland Institute of Medical Research, Brisbane, Queensland, Australia
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  • and 1,2 P. E. Hickman 3,

    Corresponding author
    1. Departments of 1Gastroenterology and Hepatology, 3Chemical Pathology and 4Immunology, Princess Alexandra Hospital,2University of Queensland and 5Queensland Institute of Medical Research, Brisbane, Queensland, Australia
      Peter E. Hickman, ANU Medical School and ACT Pathology, Canberra Hospital, PO Box 11, Woden, ACT 606, Australia.
      Email: peter.hickman@act.gov.au
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      ‡ANU Medical School and ACT Pathology, Canberra, ACT, Australia

  • Current address: Department of Gastroenterology and Hepatology, Royal Brisbane Hospital, Brisbane, Qld and ANU Medical School and ACT Pathology, Canberra, ACT, Australia

Peter E. Hickman, ANU Medical School and ACT Pathology, Canberra Hospital, PO Box 11, Woden, ACT 606, Australia.
Email: peter.hickman@act.gov.au

Abstract

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.

Aims:  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.

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