RESUMEN
Hereditary haemochromatosis (HH) is the most common lethal monogenic human disease, affecting roughly 1 in 300 white northern Europeans. Homozygosity for the C282Y polymorphism within the HFE gene causes more than 80% of cases, with compound heterozygosity of the C282Y and H63D polymorphism also increasing susceptibility to disease. The aim of this study was to determine the frequency of the C282Y and H63D polymorphisms in the disease, and to assess the risk of HH in heterozygotes for the C282Y polymorphism. 128 patients were recruited because of either radiographic chondrocalcinosis (at least bicompartmental knee disease or joints other than the knee involved) or CPPD pseudogout. Genotyping of the HFE C282Y and H63D mutations was performed using PCR/SSP and genotypes for the C282Y polymorphism confirmed by PCR/RFLP. Historical white European control data were used for comparison. Two previously undiagnosed C282Y homozygotes (1.6%), and 16 C282Y heterozygotes (12.5%), including four (3.1%) C282Y/H63D compound heterozygotes were identified. This represents a significant overrepresentation of C282Y homozygotes (relative risk 3.4, p=0.037), but the number of heterozygotes was not significantly increased. At a cost per test of pound1 for each subject, screening all patients with chondrocalcinosis using the above ascertainment criteria costs only pound64 for each case of haemochromatosis identified, clearly a highly cost effective test given the early mortality associated with untreated haemochromatosis. Routine screening for haemochromatosis in patients with appreciable chondrocalcinosis is recommended.
Asunto(s)
Condrocalcinosis/genética , Hemocromatosis/genética , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Frecuencia de los Genes , Pruebas Genéticas/métodos , Heterocigoto , Homocigoto , Humanos , Masculino , Persona de Mediana Edad , Mutación/genética , Polimorfismo Genético , Factores de RiesgoRESUMEN
Adolescence is a period of emotional and physical upheaval and a time when personal identity, need for independence, and peer relationships all evolve. This transition from dependence to independence can be a difficult process for healthy teenagers. Those with chronic illness and disability have additional concerns, rendering them especially vulnerable as they progress into adulthood.