TSAT-Urated Insights: Clarifying the Complexities of Hereditary Hemochromatosis and Its Guidelines

Hereditary hemochromatosis (HH) related to HFE-gene mutations is a well-known condition, yet its understanding remains complex. The BIOIRON classification emphasizes that only homozygosity for the C282Y mutation should be considered pathogenic. The penetrance of HFE-related HH is highly variable. Sy...

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Main Authors: Chiara Marcon, Marta Medeot, Alessio Michelazzi, Valentina Simeon, Alessandra Poz, Sara Cmet, Elisabetta Fontanini, Anna Rosa Cussigh, Marianna Chiozzotto, Giovanni Barillari
Format: Article
Language:English
Published: MDPI AG 2024-12-01
Series:Hemato
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Online Access:https://www.mdpi.com/2673-6357/5/4/35
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author Chiara Marcon
Marta Medeot
Alessio Michelazzi
Valentina Simeon
Alessandra Poz
Sara Cmet
Elisabetta Fontanini
Anna Rosa Cussigh
Marianna Chiozzotto
Giovanni Barillari
author_facet Chiara Marcon
Marta Medeot
Alessio Michelazzi
Valentina Simeon
Alessandra Poz
Sara Cmet
Elisabetta Fontanini
Anna Rosa Cussigh
Marianna Chiozzotto
Giovanni Barillari
author_sort Chiara Marcon
collection DOAJ
description Hereditary hemochromatosis (HH) related to HFE-gene mutations is a well-known condition, yet its understanding remains complex. The BIOIRON classification emphasizes that only homozygosity for the C282Y mutation should be considered pathogenic. The penetrance of HFE-related HH is highly variable. Symptoms are often challenging to recognize at the time of presentation, and the systemic involvement may overlap with other diseases. Hyperferritinemia and elevated transferrin saturation levels are still the milestones in HH diagnosis, but they are also common findings in many other clinical conditions. Furthermore, current diagnostic and therapeutic guidelines are not always unequivocal in defining HH patients’ characteristics, as well as treatment management and goals. Our work provides a concise overview of the latest evidence regarding pathogenic mechanisms, clinical picture, differential diagnosis and diagnostic tools. Alongside this, it summarizes and compares the main recommendations from principal guidelines issued by the 2017 Hemochromatosis International Meeting, the American College of Gastroenterology, the European Association for the Study of the Liver, the European Molecular Genetics Quality Network, the DUTCH guidelines, and the British Society for Haematology. Summarizing tables for quick consultation are also provided.
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institution DOAJ
issn 2673-6357
language English
publishDate 2024-12-01
publisher MDPI AG
record_format Article
series Hemato
spelling doaj-art-9deaa55654d84e79899e665e54c237dd2025-08-20T02:50:59ZengMDPI AGHemato2673-63572024-12-015445948910.3390/hemato5040035TSAT-Urated Insights: Clarifying the Complexities of Hereditary Hemochromatosis and Its GuidelinesChiara Marcon0Marta Medeot1Alessio Michelazzi2Valentina Simeon3Alessandra Poz4Sara Cmet5Elisabetta Fontanini6Anna Rosa Cussigh7Marianna Chiozzotto8Giovanni Barillari9Departement of Blood Transfusion Medicine, S. Maria della Misericordia Hospital, Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, ItalyDepartement of Blood Transfusion Medicine, S. Maria della Misericordia Hospital, Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, ItalyDivision of Laboratory Medicine, S. Maria della Misericordia Hospital, Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, ItalyDepartement of Blood Transfusion Medicine, S. Maria della Misericordia Hospital, Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, ItalyDepartment of Hemorrhagic and Thrombotic Diseases, S. Maria della Misericordia Hospital, Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, ItalyDivision of Laboratory Medicine, S. Maria della Misericordia Hospital, Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, ItalyDivision of Laboratory Medicine, S. Maria della Misericordia Hospital, Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, ItalyDivision of Laboratory Medicine, S. Maria della Misericordia Hospital, Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, ItalyDepartement of Blood Transfusion Medicine, S. Maria della Misericordia Hospital, Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, ItalyDepartement of Blood Transfusion Medicine, S. Maria della Misericordia Hospital, Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, ItalyHereditary hemochromatosis (HH) related to HFE-gene mutations is a well-known condition, yet its understanding remains complex. The BIOIRON classification emphasizes that only homozygosity for the C282Y mutation should be considered pathogenic. The penetrance of HFE-related HH is highly variable. Symptoms are often challenging to recognize at the time of presentation, and the systemic involvement may overlap with other diseases. Hyperferritinemia and elevated transferrin saturation levels are still the milestones in HH diagnosis, but they are also common findings in many other clinical conditions. Furthermore, current diagnostic and therapeutic guidelines are not always unequivocal in defining HH patients’ characteristics, as well as treatment management and goals. Our work provides a concise overview of the latest evidence regarding pathogenic mechanisms, clinical picture, differential diagnosis and diagnostic tools. Alongside this, it summarizes and compares the main recommendations from principal guidelines issued by the 2017 Hemochromatosis International Meeting, the American College of Gastroenterology, the European Association for the Study of the Liver, the European Molecular Genetics Quality Network, the DUTCH guidelines, and the British Society for Haematology. Summarizing tables for quick consultation are also provided.https://www.mdpi.com/2673-6357/5/4/35hereditary hemochromatosishyperferritinemiatransferrin saturation levelsdifferential diagnosisguidelines
spellingShingle Chiara Marcon
Marta Medeot
Alessio Michelazzi
Valentina Simeon
Alessandra Poz
Sara Cmet
Elisabetta Fontanini
Anna Rosa Cussigh
Marianna Chiozzotto
Giovanni Barillari
TSAT-Urated Insights: Clarifying the Complexities of Hereditary Hemochromatosis and Its Guidelines
Hemato
hereditary hemochromatosis
hyperferritinemia
transferrin saturation levels
differential diagnosis
guidelines
title TSAT-Urated Insights: Clarifying the Complexities of Hereditary Hemochromatosis and Its Guidelines
title_full TSAT-Urated Insights: Clarifying the Complexities of Hereditary Hemochromatosis and Its Guidelines
title_fullStr TSAT-Urated Insights: Clarifying the Complexities of Hereditary Hemochromatosis and Its Guidelines
title_full_unstemmed TSAT-Urated Insights: Clarifying the Complexities of Hereditary Hemochromatosis and Its Guidelines
title_short TSAT-Urated Insights: Clarifying the Complexities of Hereditary Hemochromatosis and Its Guidelines
title_sort tsat urated insights clarifying the complexities of hereditary hemochromatosis and its guidelines
topic hereditary hemochromatosis
hyperferritinemia
transferrin saturation levels
differential diagnosis
guidelines
url https://www.mdpi.com/2673-6357/5/4/35
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