Vautier G, Murray M, Olynyk J K
Royal Defence Medical College, Gosport, UK.
Med J Aust. 2001 Oct 15;175(8):418-21. doi: 10.5694/j.1326-5377.2001.tb143650.x.
Hereditary haemochromatosis is common, affecting one in 200 Australians of Anglo-Celtic descent; it results in iron overload affecting many organs, including the liver, heart, endocrine and musculoskeletal system. Diagnosis requires a high index of suspicion, as presenting symptoms and signs may be non-specific. Once suspected, hereditary haemochromatosis can be readily diagnosed by measurement of serum transferrin saturation and ferritin level, followed by genetic assessment. Homozygosity for the C282Y mutation in the HFE gene accounts for most cases in people of Anglo-Celtic descent in Australia; a genetic test for this mutation is widely available. Liver biopsy is advocated only in selected individuals at risk of cirrhosis or with an unclear diagnosis. Therapeutic phlebotomy remains the treatment and, if instituted early, will prevent many of the organ-specific complications.
遗传性血色素沉着症很常见,在200名英裔凯尔特血统的澳大利亚人中就有1人受其影响;它会导致铁过载,影响包括肝脏、心脏、内分泌和肌肉骨骼系统在内的许多器官。诊断需要高度的怀疑指数,因为出现的症状和体征可能不具特异性。一旦怀疑,遗传性血色素沉着症可通过测量血清转铁蛋白饱和度和铁蛋白水平,随后进行基因评估来轻松诊断。HFE基因中C282Y突变的纯合子在澳大利亚英裔凯尔特血统人群中占大多数病例;针对该突变的基因检测广泛可用。仅在有肝硬化风险或诊断不明确的特定个体中提倡进行肝活检。治疗性放血仍然是治疗方法,如果早期进行,将预防许多器官特异性并发症。
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