Appropriate Clinical Genetic Testing of Hemochromatosis Type 2–4, Including Ferroportin Disease

Abstract

Devan S Kowdley, Kris V Kowdley Liver Institute Northwest and Elson S. Floyd College of Medicine, Washington State University, Seattle, WA, USACorrespondence: Kris V KowdleyLiver Institute Northwest, 3216 NE 45th Place Suite 212, Seattle, WA, 98105, USATel [phone]Fax [phone]Email [email protected]: Hereditary hemochromatosis (HH) is an inherited iron overload disorder due to a deficiency of hepcidin, or a failure of hepcidin to degrade ferroportin. The most common form of HH, Type 1 HH, is most commonly due to a homozygous C282Y mutation in HFE and is relatively well understood in significance and action; however, other rare forms of HH (Types 2– 4) exist and are more difficult to identify and diagnose in clinical practice. In this review, we describe the clinical characteristics of HH Type 2– 4 and the mutation patterns that have been described in these conditions. We also review the different methods for genetic testing available in clinical practice and a pragmatic approach to the patient with suspected non-HFE HH.Keywords: non-HFE, hemochromatosis, juvenile hemochromatosis, ferroportin disease, transferrin-receptor 2, HAMP, hepcidin

Keywords

• non-hfe
• hemochromatosis
• juvenile hemochromatosis
• ferroportin disease
• transferrin-receptor 2
• hamp
• hepcidin