Rihl M, Kellner H
Medizinische Hochschule Hannover, Abteilung Rheumatologie, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
Z Rheumatol. 2004 Feb;63(1):22-9. doi: 10.1007/s00393-004-0563-x.
Hereditary hemochromatosis (HH) is the most common autosomal recessive disorder in populations of caucasian origin with a prevalence of 1 : 200-400 for homozygous patients. Currently, 4 types of HH are distinguished. The classical and most common form is type 1 hemochromatosis which is characterized by HFE gene mutations on chromosome 6. The disease results from an excessive iron absorption leading to multiple manifestations such as hepatomegaly, diabetes mellitus, cardiomyopathy, infertility, and hepatic fibrosis/cirrhosis if untreated. A distinct clinical feature of hemochromatosis is represented by involvement of the joints (arthropathy of hemochromatosis) which occurs frequently and often before iron overload is present. Severity of arthropathy usually does not correlate with the extent of iron overload. In contrast to most other manifestations, it is not improved by iron depletion but can be treated symptomatically. This review outlines clinical aspects as well as pathogenesis, diagnosis and therapy of the disease.
遗传性血色素沉着症(HH)是白种人最常见的常染色体隐性疾病,纯合子患者的患病率为1:200至400。目前,HH可分为4种类型。经典且最常见的形式是1型血色素沉着症,其特征是6号染色体上的HFE基因突变。该疾病是由于铁吸收过多导致的,如果不进行治疗,会引发多种症状,如肝肿大、糖尿病、心肌病、不孕以及肝纤维化/肝硬化。血色素沉着症的一个显著临床特征是关节受累(血色素沉着症性关节病),这种情况经常出现,且往往在出现铁过载之前就已发生。关节病的严重程度通常与铁过载的程度无关。与大多数其他症状不同,铁消耗并不能改善这种情况,但可以进行对症治疗。本综述概述了该疾病的临床方面以及发病机制、诊断和治疗方法。